Individual
ANDREA MEDEIROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW, LCADC
Contact information
Practice address
700 AIRPORT RD, LAKEWOOD, NJ 08701
(732) 367-4700
Mailing address
1113 OLD FREEHOLD RD, TOMS RIVER, NJ 08753-5205
(848) 992-1830
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00197400
NJ
101YA0400X
Addiction (Substance Use Disorder) Counselor
44SL05865300
NJ
Other
Enumeration date
04/08/2013
Last updated
06/21/2018
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