Provider Demographics
NPI:1336934363
Name:PADGETT, ANDREA JONES (MRT DV PROVIDER)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:JONES
Last Name:PADGETT
Suffix:
Gender:
Credentials:MRT DV PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 N CENTRAL VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:CENTRAL POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97502-1571
Mailing Address - Country:US
Mailing Address - Phone:541-499-9487
Mailing Address - Fax:
Practice Address - Street 1:446 N CENTRAL VALLEY DR
Practice Address - Street 2:
Practice Address - City:CENTRAL POINT
Practice Address - State:OR
Practice Address - Zip Code:97502-1571
Practice Address - Country:US
Practice Address - Phone:541-499-9487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor