Healthcare Provider Details

I. General information

NPI: 1649364266
Provider Name (Legal Business Name): ANDEE KRISTEN CANTAVERO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANDEE CANTAVERO LCSW

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 PEARL ST FL 2
PORT CHESTER NY
10573-4611
US

IV. Provider business mailing address

667 STONELEIGH AVE STE 202
CARMEL NY
10512-2455
US

V. Phone/Fax

Practice location:
  • Phone: 914-265-2762
  • Fax: 914-653-8282
Mailing address:
  • Phone: 845-279-5908
  • Fax: 845-622-5055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number005379
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number056423
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: