Provider Demographics
NPI:1205911674
Name:ORAVEC, ANDREA J (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:J
Last Name:ORAVEC
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 1:1269 PEBBLE BEACH RD
Mailing Address - Street 2:
Mailing Address - City:TOBYHANNA
Mailing Address - State:PA
Mailing Address - Zip Code:18466-9119
Mailing Address - Country:US
Mailing Address - Phone:570-894-0167
Mailing Address - Fax:
Practice Address - Street 1:340 MONTAGE MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:MOOSIC
Practice Address - State:PA
Practice Address - Zip Code:18507-1782
Practice Address - Country:US
Practice Address - Phone:570-346-3686
Practice Address - Fax:570-346-5301
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0125471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA814984OtherFIRST PRIORITY
PA025827Q7XMedicare ID - Type Unspecified
PA814954OtherFIRST PRIORITY
PA025827Q97Medicare ID - Type Unspecified