Andrew M Harrell Sr.
Individual provider Active NPI Professional Counselor · Jasper, FL
NPI 1952480105 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1952480105
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- MH 3789 (FL)
- Practice address
- 11180 NE 38TH St
Jasper, FL 32052-2502 - Phone
- (386) 792-6638
- Fax
- (386) 792-6401
- NPI assigned
- Nov 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH 3789 | FL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amh Counseling P.L. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | MH 3789 | FL | Yes |
Addresses
Primary practice location
11180 NE 38TH St
Jasper, FL 32052-2502
Mailing address
10333 124TH St
Live Oak, FL 32060-6958
Phone (386) 362-6483
Other providers in Jasper, FL
- Hamilton County School Board
- Hamilton County School Board
- Hamilton County School Board
- Hamilton County School Board
- Hamilton Health Enterprises, Inc.
- Hawks Transportation
- HC Healthcare Inc
- Heart 2 Heart Healthcare Services
- Anthony James Holden
- Holiday CVS LLC
All providers in Jasper, FL · Professional Counselor in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.