Provider Demographics
NPI:1851561617
Name:HAK, ANDRAI (MENTAL HEALTH COUNSE)
Entity Type:Individual
Prefix:MR
First Name:ANDRAI
Middle Name:
Last Name:HAK
Suffix:
Gender:M
Credentials:MENTAL HEALTH COUNSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4715 LIGHTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-1617
Mailing Address - Country:US
Mailing Address - Phone:321-438-4032
Mailing Address - Fax:407-578-3961
Practice Address - Street 1:2950 ALOMA AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3662
Practice Address - Country:US
Practice Address - Phone:407-975-0400
Practice Address - Fax:407-696-4831
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-08
Last Update Date:2008-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH6213101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health