MEDICARE: DR. ANDREA M STERN PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	0810003362	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	712459000	OTHER	VA	MAGELLAN
2	17384	OTHER	VA	ANTHEM BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154435303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREA M STERN PSY.D.

Provider Business Mailing Address
First Line	:	4110 E PARHAM RD STE 208
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23228-2754
Country	:	US
Telephone Number	:	804-396-3243
Fax Number	:

Provider Business Practice Location Address
First Line	:	4110 E PARHAM RD STE 208
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23228-2754
Country	:	US
Telephone Number	:	804-396-3243
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	08/07/2020

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