Provider Demographics
NPI:1760563894
Name:MATHEWS, ANDREA C (LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:C
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 11TH AVE. SOUTH
Mailing Address - Street 2:SUITE 218
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-2844
Mailing Address - Country:US
Mailing Address - Phone:205-328-0780
Mailing Address - Fax:205-328-0760
Practice Address - Street 1:2112 11TH AVE. SOUTH
Practice Address - Street 2:SUITE 218
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-2844
Practice Address - Country:US
Practice Address - Phone:205-328-0780
Practice Address - Fax:205-328-0760
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1249101YP2500X
NC2972101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional