Provider Demographics
NPI:1629558564
Name:JOSEPHS, ANDREA D
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:D
Last Name:JOSEPHS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2816 CHRISTOPHER FARMS DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BCH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-6681
Mailing Address - Country:US
Mailing Address - Phone:757-536-3257
Mailing Address - Fax:757-430-1869
Practice Address - Street 1:2816 CHRISTOPHER FARMS DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BCH
Practice Address - State:VA
Practice Address - Zip Code:23453-6681
Practice Address - Country:US
Practice Address - Phone:757-536-3257
Practice Address - Fax:757-430-1869
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor