Healthcare Provider Details

I. General information

NPI: 1144694563
Provider Name (Legal Business Name): ANDREW SHAND LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2015
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3406 GLACIER HWY
JUNEAU AK
99801-9501
US

IV. Provider business mailing address

411 W 114TH ST
NEW YORK NY
10025-1710
US

V. Phone/Fax

Practice location:
  • Phone: 907-463-3303
  • Fax:
Mailing address:
  • Phone: 212-523-4028
  • Fax: 212-523-4069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number139880
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: