MEDICARE: ANDROK SERVICES, PLLC

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	261QM0855X	Adolescent and Children Mental Health Clinic/Center

General Provider Information

NPI Number	:	1710662978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDROK SERVICES, PLLC

Provider Business Mailing Address
First Line	:	3776 LAKE SHORE DR
Second Line	:
City	:	LAUDERDALE
State	:	MS
Zip	:	39335-9426
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3776 LAKE SHORE DR
Second Line	:
City	:	LAUDERDALE
State	:	MS
Zip	:	39335-9426
Country	:	US
Telephone Number	:	601-917-1506
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	STACY RAE ANDREACCHIO
Credential	:	FPMHNP
Telephone Number	:	601-917-1506

Provider Enumeration Date	:	06/15/2023
Last Update Date	:	03/04/2026

Similar Medicare Providers

1366398760 — QUADACIA BRENEA WALKER
Practice Location Address:

381 TERRY RD
LAUDERDALE, MS
39335-8324

Practice Phone: 601-701-5169
Practice Fax:

1831648732 — LAUREN PETERSON SPECHT BCBA
Practice Location Address:

8969 FULTON DR
LAUDERDALE, MS
39335-9437

Practice Phone: 901-258-6011
Practice Fax:

1659848257 — HANNAH GRACE DAVIS
Practice Location Address:

3612 MELDA DR
LAUDERDALE, MS
39335-9411

Practice Phone: 601-917-3335
Practice Fax:

1952036212 — KEOSHA MCGLOTHIN
Practice Location Address:

81 OLD ROCK RD
LAUDERDALE, MS
39335-8337

Practice Phone: 601-851-6002
Practice Fax:

1174233449 — LARALEIGH ROBERTS ATC
Practice Location Address:

4182 WILD DUCK DR
LAUDERDALE, MS
39335-9515

Practice Phone: 601-604-9983
Practice Fax:

1093496929 — BIANCA RUSH
Practice Location Address:

10415 RABBIT RD LOT 6
LAUDERDALE, MS
39335-9609

Practice Phone: 601-490-4063
Practice Fax:

Directions to “ANDROK SERVICES, PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.