Provider Demographics
NPI:1275946261
Name:D'ANDREA, BARRY (LPC)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:
Last Name:D'ANDREA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 MORRIS ST
Mailing Address - Street 2:UNIT A
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06114-6022
Mailing Address - Country:US
Mailing Address - Phone:860-987-9848
Mailing Address - Fax:
Practice Address - Street 1:80 MORRIS ST
Practice Address - Street 2:APT A
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06114-6022
Practice Address - Country:US
Practice Address - Phone:860-987-9848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-06
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2384101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2384OtherLICENSED PROFESSIONAL COUNSELOR