Provider Demographics
NPI:1063670982
Name:CHIODO, ANDREW (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:
Last Name:CHIODO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 FIFTH AVENUE
Mailing Address - Street 2:SUITE 620
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-7002
Mailing Address - Country:US
Mailing Address - Phone:917-513-7290
Mailing Address - Fax:
Practice Address - Street 1:156 5TH AVE
Practice Address - Street 2:SUITE 620
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7002
Practice Address - Country:US
Practice Address - Phone:917-513-7290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR046225-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical