Provider Demographics
NPI:1114466869
Name:WILLIAMS, ANDREA MICHELLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MICHELLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5008 VANE CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-1526
Mailing Address - Country:US
Mailing Address - Phone:301-202-3739
Mailing Address - Fax:301-885-0922
Practice Address - Street 1:10665 STANHAVEN PL STE 3119
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3055
Practice Address - Country:US
Practice Address - Phone:301-202-3739
Practice Address - Fax:240-602-6702
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-14
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05717103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical