Provider Demographics
NPI:1760666994
Name:ANDOLINA, SIMONE (MSW)
Entity Type:Individual
Prefix:MR
First Name:SIMONE
Middle Name:
Last Name:ANDOLINA
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 GREEN STREET
Mailing Address - Street 2:JEWISH FAMILY SERVICES OF ULSTER COUNTY
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401
Mailing Address - Country:US
Mailing Address - Phone:845-338-2980
Mailing Address - Fax:
Practice Address - Street 1:159 GREEN STREET
Practice Address - Street 2:JEWISH FAMILY SERVICES OF ULSTER COUNTY
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401
Practice Address - Country:US
Practice Address - Phone:845-338-2980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO55549-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health