Provider Demographics
NPI:1942993944
Name:HAMILTON, ANDREA (LGPC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:672 OLD MILL RD STE 176
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1363
Mailing Address - Country:US
Mailing Address - Phone:703-638-2602
Mailing Address - Fax:
Practice Address - Street 1:672 OLD MILL RD STE 176
Practice Address - Street 2:
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108-1363
Practice Address - Country:US
Practice Address - Phone:703-638-2602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP13791101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health