Healthcare Provider Details

I. General information

NPI: 1609901107
Provider Name (Legal Business Name): ANDREA LYNN HANFORD M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 CLARIDGE ELLIOTT RD
JEANNETTE PA
15644-4534
US

IV. Provider business mailing address

1229 CLARIDGE ELLIOTT RD
JEANNETTE PA
15644-4534
US

V. Phone/Fax

Practice location:
  • Phone: 412-610-2318
  • Fax:
Mailing address:
  • Phone: 412-610-2318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC015587
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: