Provider Demographics
NPI:1023275088
Name:CHIAPPA, ANDREA SIMANDY (LPC)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:SIMANDY
Last Name:CHIAPPA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 UNION ST
Mailing Address - Street 2:
Mailing Address - City:DEEP RIVER
Mailing Address - State:CT
Mailing Address - Zip Code:06417-1749
Mailing Address - Country:US
Mailing Address - Phone:860-526-5340
Mailing Address - Fax:
Practice Address - Street 1:158 UNION ST
Practice Address - Street 2:
Practice Address - City:DEEP RIVER
Practice Address - State:CT
Practice Address - Zip Code:06417-1749
Practice Address - Country:US
Practice Address - Phone:860-526-5340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001132101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT240001132CT02OtherBLUE CROSS AND BLUE SHIELD