Provider Demographics
NPI:1164098638
Name:DICRISTOFARO, ANDREA M (LMSW)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:M
Last Name:DICRISTOFARO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:M
Other - Last Name:LAROSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:UNION PLEASANT ELEMENTARY
Mailing Address - Street 2:150 PLEASANT AVE,
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-4828
Mailing Address - Country:US
Mailing Address - Phone:716-646-3280
Mailing Address - Fax:
Practice Address - Street 1:UNION PLEASANT ELEMENTARY
Practice Address - Street 2:150 PLEASANT AVE,
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-4828
Practice Address - Country:US
Practice Address - Phone:716-646-3280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor