Provider Demographics
NPI:1083966592
Name:ANDREWS, SAMUEL JAMAL
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:JAMAL
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3415 CLEAR ACRE LN
Mailing Address - Street 2:C
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512-1481
Mailing Address - Country:US
Mailing Address - Phone:775-560-3262
Mailing Address - Fax:
Practice Address - Street 1:2655 ENTERPRISE RD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-1666
Practice Address - Country:US
Practice Address - Phone:775-688-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health