Provider Demographics
NPI:1265986327
Name:ANDREA R. PRZYBYLSKI, LMHC
Entity type:Organization
Organization Name:ANDREA R. PRZYBYLSKI, LMHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:MOJICA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:315-558-7374
Mailing Address - Street 1:8290 SWALLOW PATH
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-1024
Mailing Address - Country:US
Mailing Address - Phone:315-558-7374
Mailing Address - Fax:
Practice Address - Street 1:4317 E GENESEE ST
Practice Address - Street 2:SUITE 204
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13214-2114
Practice Address - Country:US
Practice Address - Phone:315-558-7374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-06
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006295101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty