MEDICARE: ANDREA BATTIOLA LPC

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	101YP2500X	Professional Counselor	PRC14849	DC

General Provider Information

NPI Number	:	1174918437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA BATTIOLA LPC

Provider Business Mailing Address
First Line	:	1133 E WEST HWY
Second Line	:	APT 928W
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-4804
Country	:	US
Telephone Number	:	920-819-0659
Fax Number	:

Provider Business Practice Location Address
First Line	:	1250 CONNECTICUT AVE NW
Second Line	:	200
City	:	WASHINGTON
State	:	DC
Zip	:	20036-2603
Country	:	US
Telephone Number	:	920-819-0659
Fax Number	:

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

Provider Enumeration Date	:	04/03/2015
Last Update Date	:	12/01/2016

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