Provider Demographics
NPI:1710637715
Name:RODNEY, ANDREA K (PHD DOCTORATE)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:K
Last Name:RODNEY
Suffix:
Gender:F
Credentials:PHD DOCTORATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7604 VICAR PL
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-2966
Mailing Address - Country:US
Mailing Address - Phone:202-696-7183
Mailing Address - Fax:
Practice Address - Street 1:7604 VICAR PL
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-2966
Practice Address - Country:US
Practice Address - Phone:202-823-9346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC101YP1600X, 103TM1800X
MD103K00000X, 106S00000X
133NN1002X
LALEHP669171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education