Provider Demographics
NPI:1619284510
Name:CUDA, ANDRE F (LMSW)
Entity type:Individual
Prefix:
First Name:ANDRE
Middle Name:F
Last Name:CUDA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 SALISBURY ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13365-1555
Mailing Address - Country:US
Mailing Address - Phone:315-985-5950
Mailing Address - Fax:315-868-1046
Practice Address - Street 1:417 E GERMAN ST
Practice Address - Street 2:
Practice Address - City:HERKIMER
Practice Address - State:NY
Practice Address - Zip Code:13350-1028
Practice Address - Country:US
Practice Address - Phone:315-985-5950
Practice Address - Fax:315-868-1000
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081071101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health