Provider Demographics
NPI:1841867330
Name:BENNETT, ANDREA PARRIS (LPC, AADC, NCC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:PARRIS
Last Name:BENNETT
Suffix:
Gender:F
Credentials:LPC, AADC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 5TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:ATTALLA
Mailing Address - State:AL
Mailing Address - Zip Code:35954-2202
Mailing Address - Country:US
Mailing Address - Phone:256-279-7755
Mailing Address - Fax:256-646-2233
Practice Address - Street 1:317 5TH AVE NW
Practice Address - Street 2:
Practice Address - City:ATTALLA
Practice Address - State:AL
Practice Address - Zip Code:35954-2202
Practice Address - Country:US
Practice Address - Phone:256-279-7755
Practice Address - Fax:256-646-2233
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-04
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL160101YA0400X
AL3771101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL3771OtherALABAMA BOARD OF EXAMINERS IN COUNSELING