Provider Demographics
NPI:1588913313
Name:SPRAGUE, EDWARD ARTHUR IV (CADC-II)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:ARTHUR
Last Name:SPRAGUE
Suffix:IV
Gender:M
Credentials:CADC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1896 NIGHTSONG LN
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1790
Mailing Address - Country:US
Mailing Address - Phone:530-898-1888
Mailing Address - Fax:
Practice Address - Street 1:40 LANDING CIR STE 1
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-7901
Practice Address - Country:US
Practice Address - Phone:530-514-4581
Practice Address - Fax:530-898-0239
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA6981011101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)