Provider Demographics
NPI:1265621684
Name:ANDREWS, JOHN A (MS LADC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:MS LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-0368
Mailing Address - Country:US
Mailing Address - Phone:802-748-3181
Mailing Address - Fax:802-748-0704
Practice Address - Street 1:2225 PORTLAND STREET
Practice Address - Street 2:
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819
Practice Address - Country:US
Practice Address - Phone:802-748-3181
Practice Address - Fax:802-748-0704
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT000415101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor