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 1:176 E 176TH ST APT 44
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-5630
Mailing Address - Country:US
Mailing Address - Phone:646-305-0262
Mailing Address - Fax:
Practice Address - Street 1:1090 SAINT NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3809
Practice Address - Country:US
Practice Address - Phone:212-543-4445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)