Provider Demographics
NPI:1598961336
Name:TROY, ANDREA (MSW)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:TROY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:TROY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:220 E 94TH ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3901
Mailing Address - Country:US
Mailing Address - Phone:212-289-1705
Mailing Address - Fax:212-289-1705
Practice Address - Street 1:220 E 94TH ST APT 2B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3901
Practice Address - Country:US
Practice Address - Phone:212-289-1705
Practice Address - Fax:212-289-1705
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR033699-1104100000X
NY033699-11041C0700X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No174400000XOther Service ProvidersSpecialist