Healthcare Provider Details

I. General information

NPI: 1326983099
Provider Name (Legal Business Name): ANDREA SKY SCOTT LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1554 UNIONPORT RD
BRONX NY
10462-7819
US

IV. Provider business mailing address

1554 UNIONPORT RD
BRONX NY
10462-7819
US

V. Phone/Fax

Practice location:
  • Phone: 917-673-9083
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number128789
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: