Provider Demographics
NPI:1578070629
Name:STERLING, KAIDEN ANDREW DERRICK
Entity Type:Individual
Prefix:
First Name:KAIDEN
Middle Name:ANDREW DERRICK
Last Name:STERLING
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 1:820 APPLE HILL DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-3339
Mailing Address - Country:US
Mailing Address - Phone:972-836-8996
Mailing Address - Fax:
Practice Address - Street 1:550 S WATTERS RD STE 261
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5231
Practice Address - Country:US
Practice Address - Phone:972-836-8996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-10
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor