Healthcare Provider Details

I. General information

NPI: 1801934617
Provider Name (Legal Business Name): ANDREW JOSEPH MA, LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DREW JOSEPH MA, LMFT

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 19TH ST NW SUITE 200
WASHINGTON DC
20036-1610
US

IV. Provider business mailing address

1320 19TH ST NW SUITE 200
WASHINGTON DC
20036-1610
US

V. Phone/Fax

Practice location:
  • Phone: 202-280-5003
  • Fax:
Mailing address:
  • Phone: 202-280-5003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC40825
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT000022
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: