MEDICARE: ANDREA HAMM

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	103K00000X	Behavior Analyst	1-25-84251	VA
2	106S00000X	Behavior Technician	RBT-23-270238	VA

General Provider Information

NPI Number	:	1740874338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA HAMM

Provider Business Mailing Address
First Line	:	1410 SPRING HILL RD STE 305
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22102-3020
Country	:	US
Telephone Number	:
Fax Number	:	833-220-8662

Provider Business Practice Location Address
First Line	:	7420 FULLERTON RD STE 110
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22153-2836
Country	:	US
Telephone Number	:	571-463-7174
Fax Number	:

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

Provider Enumeration Date	:	02/24/2021
Last Update Date	:	10/21/2025

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Directions to “ ANDREA HAMM ” Practice Location

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