Provider Demographics
NPI:1386190296
Name:GRECO, ANDREA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:GRECO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2814 42ND ST APT D4
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-2925
Mailing Address - Country:US
Mailing Address - Phone:917-780-2918
Mailing Address - Fax:
Practice Address - Street 1:2814 42ND ST APT D4
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-2925
Practice Address - Country:US
Practice Address - Phone:917-780-2918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY098348-1104100000X
NY090451011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker