Provider Demographics
NPI:1215384490
Name:VINTON, ANDREA T (LPCC, LPC, MHC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:T
Last Name:VINTON
Suffix:
Gender:
Credentials:LPCC, LPC, MHC
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:RENATE
Other - Last Name:TOMOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANDREA T SHARPLES
Mailing Address - Street 1:4280 W KLING ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-3702
Mailing Address - Country:US
Mailing Address - Phone:213-649-8092
Mailing Address - Fax:
Practice Address - Street 1:4280 W KLING ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-3702
Practice Address - Country:US
Practice Address - Phone:213-649-8092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-18
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC5718101YM0800X
NMCTB-2023-0601101YM0800X
WALH61408460101YM0800X
CA13043101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health