Provider Demographics
NPI:1437666500
Name:HARRELSON, ANDREA LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:LYNN
Last Name:HARRELSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 SOUTHERN BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-7457
Mailing Address - Country:US
Mailing Address - Phone:912-233-6430
Mailing Address - Fax:
Practice Address - Street 1:145 SOUTHERN BLVD STE B
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-7457
Practice Address - Country:US
Practice Address - Phone:912-233-6430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-10
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2480101YA0400X
GA2902101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)