Provider Demographics
NPI:1427376946
Name:GREGG-MARTIN, ANDREA RENEA (MA, LPC, LMHP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:RENEA
Last Name:GREGG-MARTIN
Suffix:
Gender:
Credentials:MA, LPC, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 E 6TH ST # L
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-5560
Mailing Address - Country:US
Mailing Address - Phone:804-252-1862
Mailing Address - Fax:804-655-6171
Practice Address - Street 1:700 E 6TH ST # L
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-5560
Practice Address - Country:US
Practice Address - Phone:804-252-1862
Practice Address - Fax:804-655-6171
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-07
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004838101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional