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General NPI Number Information
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NPI Number | 1215316328
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Entity Type | Individual
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Provider Name | ANDREW J CHANDLER III LPC, LSATP, CSOTP
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Gender | Male
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Dates
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Enumeration Date | 05/21/2015
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Last Update Date | 01/11/2023
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Provider Practice Location Address
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Address Line | 2160 CHURCH ST # 1
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City | APPOMATTOX
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State | VA
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Zip | 24522
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Country | US
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Telephone | 434-401-4104
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Fax | 434-664-1587
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Provider Business Mailing Address
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Address Line | 369 SOYBEAN DR
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City | APPOMATTOX
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State | VA
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Zip | 24522-4308
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Country | US
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Telephone | 434-401-4104
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Fax | 434-664-1587
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701006147
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License Number State | VA
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