Provider Demographics
NPI:1477664126
Name:FRYS, ANDREA L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:L
Last Name:FRYS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:L
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:5120 ORCHARD AVE
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-5657
Mailing Address - Country:US
Mailing Address - Phone:716-926-1710
Mailing Address - Fax:
Practice Address - Street 1:3780 S PARK AVE
Practice Address - Street 2:
Practice Address - City:BLASDELL
Practice Address - State:NY
Practice Address - Zip Code:14219-1805
Practice Address - Country:US
Practice Address - Phone:716-926-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00030241501OtherUNIVERA
NY000506354005OtherCOMMUNITY BLUE