Provider Demographics
NPI:1083293583
Name:SUTRICK, ANDREA (LMHC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:SUTRICK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6819 BERRYHILL ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-2264
Mailing Address - Country:US
Mailing Address - Phone:850-564-6881
Mailing Address - Fax:
Practice Address - Street 1:6819 BERRYHILL ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-2264
Practice Address - Country:US
Practice Address - Phone:850-748-0344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-03
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19178101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health