Provider Demographics
NPI:1639785751
Name:MATTHEWS, ANDRE E (LPCC)
Entity Type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:E
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12600 N 113TH AVE STE B8
Mailing Address - Street 2:
Mailing Address - City:YOUNGTOWN
Mailing Address - State:AZ
Mailing Address - Zip Code:85363-1163
Mailing Address - Country:US
Mailing Address - Phone:602-845-0767
Mailing Address - Fax:
Practice Address - Street 1:12600 N 113TH AVE STE B8
Practice Address - Street 2:
Practice Address - City:YOUNGTOWN
Practice Address - State:AZ
Practice Address - Zip Code:85363-1163
Practice Address - Country:US
Practice Address - Phone:602-845-0767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional