MEDICARE: ANDREA M STERN, PSY.D., LCP, PLLC

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	103T00000X	Psychologist

General Provider Information

NPI Number	:	1235760661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDREA M STERN, PSY.D., LCP, PLLC

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	:	OWNER
Name	:	ANDREA STERN
Credential	:	PSYD
Telephone Number	:	804-396-3243

Provider Enumeration Date	:	02/04/2020
Last Update Date	:	08/07/2020

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