Provider Demographics
NPI:1558840256
Name:REED, ANDREA LADAWN (CRC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:LADAWN
Last Name:REED
Suffix:
Gender:F
Credentials:CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 W HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-3411
Mailing Address - Country:US
Mailing Address - Phone:918-424-6466
Mailing Address - Fax:
Practice Address - Street 1:1101 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-4919
Practice Address - Country:US
Practice Address - Phone:918-420-5006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty