MEDICARE: ANDREA CHANDLER LCPC

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	101YM0800X	Mental Health Counselor	LC8682	MD

General Provider Information

NPI Number	:	1174307789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA CHANDLER LCPC

Provider Business Mailing Address
First Line	:	13315 HATHAWAY DR
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-3257
Country	:	US
Telephone Number	:	240-436-2410
Fax Number	:

Provider Business Practice Location Address
First Line	:	12200 TECH RD STE 330
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-1913
Country	:	US
Telephone Number	:	240-436-2410
Fax Number	:

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

Provider Enumeration Date	:	08/23/2023
Last Update Date	:	08/23/2023

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