Provider Demographics
NPI:1841957081
Name:O'CONNELL, ANDREA (LCPC)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MRS
Other - First Name:ANDI
Other - Middle Name:LEIGH
Other - Last Name:O'CONNELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA,CAS,NCSP
Mailing Address - Street 1:1332 LONDONTOWN BLVD
Mailing Address - Street 2:SUITE 115-P
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6587
Mailing Address - Country:US
Mailing Address - Phone:410-861-0341
Mailing Address - Fax:
Practice Address - Street 1:1332 LONDONTOWN BLVD
Practice Address - Street 2:SUITE 115-P
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6587
Practice Address - Country:US
Practice Address - Phone:410-861-0341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-23
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC15640101YM0800X, 101Y00000X
MDA0581101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health