Provider Demographics
NPI:1891525259
Name:MEAD, ANDREW RICHARD (SUD COUNSELOR)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:RICHARD
Last Name:MEAD
Suffix:
Gender:M
Credentials:SUD COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2955 RUSH CREEK CT
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-5204
Mailing Address - Country:US
Mailing Address - Phone:530-276-1124
Mailing Address - Fax:
Practice Address - Street 1:1401 GOLD ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1937
Practice Address - Country:US
Practice Address - Phone:530-276-1124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10061101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)