Provider Demographics
NPI:1578146452
Name:TCHEKALENKOV, ANDREW (MSW, CASAC 2)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:TCHEKALENKOV
Suffix:
Gender:M
Credentials:MSW, CASAC 2
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:753 ONDERDONK AVE APT 3R
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-3721
Mailing Address - Country:US
Mailing Address - Phone:347-409-9314
Mailing Address - Fax:
Practice Address - Street 1:25 AVENUE D
Practice Address - Street 2:NEW YORK, NY 10009
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10009
Practice Address - Country:US
Practice Address - Phone:646-395-4077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31357101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)