Healthcare Provider Details

I. General information

NPI: 1982571857
Provider Name (Legal Business Name): ANDREW KUZMICKAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20025 LUNN RD
STRONGSVILLE OH
44149-4925
US

IV. Provider business mailing address

17171 GREENWOOD DR
STRONGSVILLE OH
44149-5826
US

V. Phone/Fax

Practice location:
  • Phone: 216-299-1978
  • Fax:
Mailing address:
  • Phone: 216-299-1978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.01237
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: