Gradel, Addison Edward

Gradel, Addison Edward is an sole proprietor health care provider with primary practice located at 5701 Avenue P , Lubbock TX 79412-3674. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Gradel, Addison Edward can be contacted via phone (806) 741-0713.

Contact Information

Primary practice address
5701 Avenue P Lubbock TX 79412-3674
Phone: (806) 741-0713
Fax: (806) 741-0797
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X 6482 Texas
Behavioral Health & Social Service Providers / Psychologist 103T00000X 24085 Texas

Profile Details

NPI number 1194739706
LBN Legal business name Gradel, Addison Edward
Credentials ED.D
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 28th, 2006
Last updated Mar 1st, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194739706 NPPES
Texas MEDICAID 098566502
Texas Other G93C
Texas Other 113884100

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