Provider Demographics
NPI:1285777904
Name:SUMMER, ANDREA BETH (LCPC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:BETH
Last Name:SUMMER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 WESTWOODS RD
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-6274
Mailing Address - Country:US
Mailing Address - Phone:207-251-3877
Mailing Address - Fax:
Practice Address - Street 1:9 BEACH ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-2801
Practice Address - Country:US
Practice Address - Phone:207-251-3877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC1175101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health