Provider Demographics
NPI:1134545825
Name:CORDELL PROPER, ANDREA MICHELE (LCPC)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:MICHELE
Last Name:CORDELL PROPER
Suffix:
Gender:
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 N COURT ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-5413
Mailing Address - Country:US
Mailing Address - Phone:301-818-8100
Mailing Address - Fax:
Practice Address - Street 1:9 N COURT ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5413
Practice Address - Country:US
Practice Address - Phone:301-818-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-05
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 174H00000X, 374J00000X, 174H00000X
MD251B00000X
MDLC14184101YM0800X
MD11658101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No174H00000XOther Service ProvidersHealth Educator
No251B00000XAgenciesCase Management
No374J00000XNursing Service Related ProvidersDoula
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLC14184OtherLCPC