Provider Demographics
NPI:1154977247
Name:REIDENBACH, ANDREW LINDER (LCSW)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:LINDER
Last Name:REIDENBACH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 W 73RD ST APT 3A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-8806
Mailing Address - Country:US
Mailing Address - Phone:646-787-6966
Mailing Address - Fax:
Practice Address - Street 1:271 W 73RD ST APT 3A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-8806
Practice Address - Country:US
Practice Address - Phone:646-787-6966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2023-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0948291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical