Provider Demographics
NPI:1396997375
Name:LIVERMAN, ANDREA DAMIANI (LPC, RPT, NCC, CPCS)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:DAMIANI
Last Name:LIVERMAN
Suffix:
Gender:F
Credentials:LPC, RPT, NCC, CPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:37 W FAIRMONT AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3455
Mailing Address - Country:US
Mailing Address - Phone:912-507-2483
Mailing Address - Fax:800-513-2294
Practice Address - Street 1:37 W FAIRMONT AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3455
Practice Address - Country:US
Practice Address - Phone:912-507-2483
Practice Address - Fax:800-513-2294
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA4419101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003147595AMedicaid