MEDICARE: ANDREA DEAL 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	PRC14491	DC
2	101YP2500X	Professional Counselor	0701006500	VA

General Provider Information

NPI Number	:	1457751513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA DEAL LPC

Provider Business Mailing Address
First Line	:	2121 EISENHOWER AVE STE 307
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-4688
Country	:	US
Telephone Number	:	571-239-8812
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 EISENHOWER AVE STE 307
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-4688
Country	:	US
Telephone Number	:	571-239-8812
Fax Number	:

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

Provider Enumeration Date	:	08/26/2014
Last Update Date	:	10/02/2023

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Directions to “ ANDREA DEAL LPC” Practice Location

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