Provider Demographics
NPI:1235760661
Name:ANDREA M STERN, PSY.D., LCP, PLLC
Entity Type:Organization
Organization Name:ANDREA M STERN, PSY.D., LCP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:804-396-3243
Mailing Address - Street 1:4110 E PARHAM RD STE 208
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23228-2754
Mailing Address - Country:US
Mailing Address - Phone:804-396-3243
Mailing Address - Fax:
Practice Address - Street 1:4110 E PARHAM RD STE 208
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-2754
Practice Address - Country:US
Practice Address - Phone:804-396-3243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-04
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty