Provider Demographics
NPI:1003335340
Name:CONNELL, ANDRIA LAURINE (CMHC)
Entity Type:Individual
Prefix:MS
First Name:ANDRIA
Middle Name:LAURINE
Last Name:CONNELL
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 MADISON AVE FL 6
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5827
Mailing Address - Country:US
Mailing Address - Phone:347-844-6900
Mailing Address - Fax:
Practice Address - Street 1:477 MADISON AVE FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5827
Practice Address - Country:US
Practice Address - Phone:347-844-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009715101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health