Provider Demographics
NPI:1023836236
Name:ANDREWS, ACHANTE (LAC, LCADC)
Entity type:Individual
Prefix:
First Name:ACHANTE
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:LAC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 S 20TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-1592
Mailing Address - Country:US
Mailing Address - Phone:631-877-0969
Mailing Address - Fax:
Practice Address - Street 1:530 S 20TH ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-1592
Practice Address - Country:US
Practice Address - Phone:631-877-0969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor