Provider Demographics
NPI:1114343753
Name:EXLEY, ANDREA (LMFT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:EXLEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2187
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-2187
Mailing Address - Country:US
Mailing Address - Phone:828-631-3973
Mailing Address - Fax:828-631-9280
Practice Address - Street 1:27 BONA VISTA DR
Practice Address - Street 2:
Practice Address - City:MARBLE
Practice Address - State:NC
Practice Address - Zip Code:28905-8646
Practice Address - Country:US
Practice Address - Phone:828-631-3973
Practice Address - Fax:828-631-9280
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-06
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16593101YA0400X
NC1675106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)