Provider Demographics
NPI:1013145622
Name:QUATRALE, ANDREA LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:LYNN
Last Name:QUATRALE
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 1:7 LANDINGS LN
Mailing Address - Street 2:
Mailing Address - City:EAST PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-6306
Mailing Address - Country:US
Mailing Address - Phone:631-241-6292
Mailing Address - Fax:
Practice Address - Street 1:7 LANDINGS LN
Practice Address - Street 2:
Practice Address - City:EAST PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-6306
Practice Address - Country:US
Practice Address - Phone:631-241-6292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0440761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical