Doctor Name: | ANDY STREET |
NPI Number: | 1023019932 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 2004 |
Business Practice Address: | 3001 Scenic Hwy Gadsden, AL - 359043047 |
Business Phone Number: | 2565469265 |
Business Fax Number: | 2565490376 |
Mailing Address: | 3001 Scenic Hwy, GADSDEN |
State: | AL |
Postal Code: | 359043047 |
Phone Number: | 2565469265 |
Fax Number: | 2565490376 |
NPI Enumeration Date: | 08/02/2005 |
NPI Last Update Date: | 03/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 2004 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |