Healthcare Provider Details

I. General information

NPI: 1154911261
Provider Name (Legal Business Name): AMY PICHARDO LCSW, M-CASAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMY PICHARDO

II. Dates (important events)

Enumeration Date: 01/22/2021
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 AUDUBON AVE
NEW YORK NY
10040-3539
US

IV. Provider business mailing address

520 AUDUBON AVE APT 59
NEW YORK NY
10040-3674
US

V. Phone/Fax

Practice location:
  • Phone: 646-833-8037
  • Fax:
Mailing address:
  • Phone: 917-532-5515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number34822
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number103935
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: