Provider Demographics
NPI:1134595069
Name:ANDRE, LINZY (MSED, MHC, NCC)
Entity type:Individual
Prefix:
First Name:LINZY
Middle Name:
Last Name:ANDRE
Suffix:
Gender:F
Credentials:MSED, MHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 WEST 32ND STREET
Mailing Address - Street 2:SUITE 1502
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3841
Mailing Address - Country:US
Mailing Address - Phone:347-415-4590
Mailing Address - Fax:
Practice Address - Street 1:39 WEST 32ND STREET
Practice Address - Street 2:SUITE 1502
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3841
Practice Address - Country:US
Practice Address - Phone:347-415-4590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-14
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007735101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health