Individual
ANDREA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9593 STATE ROUTE 22, GRANVILLE, NY 12832-4819
(518) 642-9460
Mailing address
58 QUAKER ST, GRANVILLE, NY 12832-1513
(518) 642-9460
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
107593-01
NY
Other
Enumeration date
10/24/2019
Last updated
09/23/2025
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