Provider Demographics
NPI:1811109333
Name:SMITH, ANDREA LENORE (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:LENORE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 COMMODORE RD
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-2609
Mailing Address - Country:US
Mailing Address - Phone:914-238-0375
Mailing Address - Fax:914-238-0375
Practice Address - Street 1:153 E MAIN ST
Practice Address - Street 2:SUITE G
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2317
Practice Address - Country:US
Practice Address - Phone:914-238-0375
Practice Address - Fax:914-238-0375
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008666-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical