Provider Demographics
NPI:1992558548
Name:MORTON, ANDREW READ (RESIDENT COUNSELOR)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:READ
Last Name:MORTON
Suffix:
Gender:M
Credentials:RESIDENT COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2018 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-3623
Mailing Address - Country:US
Mailing Address - Phone:202-436-1967
Mailing Address - Fax:
Practice Address - Street 1:9110 RAILROAD DR STE 310A
Practice Address - Street 2:
Practice Address - City:MANASSAS PARK
Practice Address - State:VA
Practice Address - Zip Code:20111-7042
Practice Address - Country:US
Practice Address - Phone:703-334-2206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704016052101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health