1952134462 NPI number — ANDREA DEL VECCHIO LCSWR

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952134462 NPI number — ANDREA DEL VECCHIO LCSWR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEL VECCHIO
Provider First Name:
ANDREA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSWR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MUTRYN
Provider Other First Name:
ANDREA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSWR
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1952134462
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
UNION STREET COUNSELING SERVICES LLC.
Provider Second Line Business Mailing Address:
5 HEMPHILL PLACE SUITE 121
Provider Business Mailing Address City Name:
MALTA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12020-4423
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-289-5072
Provider Business Mailing Address Fax Number:
518-289-5225

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2310 NOH STREET E.
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
NISKAYUNA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12309-4303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-374-6263
Provider Business Practice Location Address Fax Number:
518-289-5225
Provider Enumeration Date:
08/21/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  044074 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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