Provider Demographics
NPI:1831409663
Name:ADHD & AUTISM PSYCHOLOGICAL SERVICES AND ADVOCACY, PLLC
Entity type:Organization
Organization Name:ADHD & AUTISM PSYCHOLOGICAL SERVICES AND ADVOCACY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ-WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-732-3431
Mailing Address - Street 1:122 BUSINESS PARK DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-6321
Mailing Address - Country:US
Mailing Address - Phone:315-732-3431
Mailing Address - Fax:866-822-2343
Practice Address - Street 1:122 BUSINESS PARK DR
Practice Address - Street 2:SUITE 1
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-6321
Practice Address - Country:US
Practice Address - Phone:315-732-3431
Practice Address - Fax:866-822-2343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02923742Medicaid