Provider Demographics
NPI:1861821506
Name:DRY, ANDREA ELIZABETH MOON (MS, NCC, LCAS, LCM)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:ELIZABETH MOON
Last Name:DRY
Suffix:
Gender:F
Credentials:MS, NCC, LCAS, LCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 LE PHILLIP CT NE STE D
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1917
Mailing Address - Country:US
Mailing Address - Phone:704-796-8468
Mailing Address - Fax:
Practice Address - Street 1:236 LE PHILLIP CT NE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-1905
Practice Address - Country:US
Practice Address - Phone:704-796-8468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-20803101YA0400X
NC10269101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional