Provider Demographics
NPI:1194917583
Name:PRICE, ANDREW GARRISON (LCSW - R)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:GARRISON
Last Name:PRICE
Suffix:
Gender:M
Credentials:LCSW - R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9578 STATE ROUTE 434
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-1070
Mailing Address - Country:US
Mailing Address - Phone:607-725-9107
Mailing Address - Fax:
Practice Address - Street 1:9578 STATE ROUTE 434
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-1070
Practice Address - Country:US
Practice Address - Phone:607-725-9107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0774111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical