Provider Demographics
NPI:1417244187
Name:STOECKER, ANDREA MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE
Last Name:STOECKER
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 1:1489 BALTIMORE PIKE STE 250
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-3974
Mailing Address - Country:US
Mailing Address - Phone:610-544-2110
Mailing Address - Fax:610-604-9510
Practice Address - Street 1:423 PARK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2803
Practice Address - Country:US
Practice Address - Phone:631-271-3591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY084978104100000X
PACW0217141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker