Active NPI
Andrea Hendricks, PH.D
- Clinical Psychologist
- Mountain BRK, AL
National Provider Identifier
1700216199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1763
- Practice address
- 402 Office Park Dr
Mountain BRK, AL 35223-2417 - Phone
- (205) 202-1428
- NPI assigned
- Nov 21, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1763 | AL | Primary |
Addresses
Primary practice location
402 Office Park Dr
Mountain BRK, AL 35223-2417
Mailing address
402 Office Park Dr
Mountain BRK, AL 35223-2417
Phone (205) 202-1428
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1763 | AL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384992000000",
"number": "1700216199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 OFFICE PARK DR",
"city": "MOUNTAIN BRK",
"state": "AL",
"postal_code": "352232417",
"telephone_number": "205-202-1428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 OFFICE PARK DR",
"city": "MOUNTAIN BRK",
"state": "AL",
"postal_code": "352232417",
"telephone_number": "205-202-1428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDRICKS",
"first_name": "ANDREA",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-21",
"last_updated": "2013-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AL",
"license": "1763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain BRK, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.