Provider Demographics
NPI:1982886891
Name:NICASIO, ANDEL VERONICA (MSED, CRC)
Entity type:Individual
Prefix:MS
First Name:ANDEL
Middle Name:VERONICA
Last Name:NICASIO
Suffix:
Gender:F
Credentials:MSED, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 E NEW ENGLAND AVE APT 203
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4346
Mailing Address - Country:US
Mailing Address - Phone:321-323-3167
Mailing Address - Fax:
Practice Address - Street 1:157 E NEW ENGLAND AVE APT 203
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4346
Practice Address - Country:US
Practice Address - Phone:321-323-3167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
FLPY12699103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)