MEDICARE: KAYLEE ANDRUSIER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	103058	NY
2	104100000X	Social Worker	21803	FL
3	104100000X	Social Worker	117085	NY

General Provider Information

NPI Number	:	1013791730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLEE ANDRUSIER LCSW

Provider Business Mailing Address
First Line	:	1544 PRESIDENT ST APT P
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11213-4586
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1544 PRESIDENT ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11213-4557
Country	:	US
Telephone Number	:	305-803-4075
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2023
Last Update Date	:	06/01/2026

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Directions to “ KAYLEE ANDRUSIER LCSW” Practice Location

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