Provider Demographics
NPI:1154637213
Name:MARRA, ANDREW JOSEPH (MS, LPC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:JOSEPH
Last Name:MARRA
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5225 N SHARTEL AVE #201
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118
Mailing Address - Country:US
Mailing Address - Phone:913-271-9640
Mailing Address - Fax:
Practice Address - Street 1:5225 N SHARTEL AVE STE 201
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-6035
Practice Address - Country:US
Practice Address - Phone:913-271-9640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
OK6448101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health