Provider Demographics
NPI:1023592250
Name:HOOVER, ANDREI DARRELL (LCSW-R, ACSW)
Entity type:Individual
Prefix:MR
First Name:ANDREI
Middle Name:DARRELL
Last Name:HOOVER
Suffix:
Gender:M
Credentials:LCSW-R, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16007 132ND AVE SIDE DOOR
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-2911
Mailing Address - Country:US
Mailing Address - Phone:347-707-0389
Mailing Address - Fax:
Practice Address - Street 1:16007 132ND AVE SIDE DOOR
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-2911
Practice Address - Country:US
Practice Address - Phone:347-707-0389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022817R101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional