Provider Demographics
NPI:1609184431
Name:ANDOLFI, COREY (MA, LMFT, NBCCH)
Entity Type:Individual
Prefix:
First Name:COREY
Middle Name:
Last Name:ANDOLFI
Suffix:
Gender:M
Credentials:MA, LMFT, NBCCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 LAKE PARK BLVD N STE 109
Mailing Address - Street 2:
Mailing Address - City:CAROLINA BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28428-3906
Mailing Address - Country:US
Mailing Address - Phone:910-294-0970
Mailing Address - Fax:910-458-4824
Practice Address - Street 1:1328 LAKE PARK BLVD N STE 109
Practice Address - Street 2:
Practice Address - City:CAROLINA BEACH
Practice Address - State:NC
Practice Address - Zip Code:28428-3906
Practice Address - Country:US
Practice Address - Phone:910-294-0970
Practice Address - Fax:910-458-4824
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist