Provider Demographics
NPI:1295531044
Name:CLEA, ADREON ALEXIS
Entity type:Individual
Prefix:
First Name:ADREON
Middle Name:ALEXIS
Last Name:CLEA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 LACONIA CIR APT 4308B
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-6269
Mailing Address - Country:US
Mailing Address - Phone:803-406-8595
Mailing Address - Fax:
Practice Address - Street 1:602 LACONIA CIR APT 4308B
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-6269
Practice Address - Country:US
Practice Address - Phone:803-406-8595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician