Provider Demographics
NPI:1699713891
Name:SHINCOVICH, ANDREA B (LCSW)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:B
Last Name:SHINCOVICH
Suffix:
Gender:F
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:PO BOX 36
Mailing Address - Street 2:
Mailing Address - City:WEST NEWTON
Mailing Address - State:PA
Mailing Address - Zip Code:15089-0036
Mailing Address - Country:US
Mailing Address - Phone:724-554-0774
Mailing Address - Fax:724-872-4327
Practice Address - Street 1:4047 OLD WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1846
Practice Address - Country:US
Practice Address - Phone:724-554-0774
Practice Address - Fax:724-872-4327
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0131851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA634579Medicare UPIN