Healthcare Provider Details

I. General information

NPI: 1942480223
Provider Name (Legal Business Name): ANDREW E. SAID LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2007
Last Update Date: 02/11/2020
Certification Date: 02/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 TERRACE DR STE 102
STROUDSBURG PA
18360-7510
US

IV. Provider business mailing address

PO BOX 288
STROUDSBURG PA
18360-0288
US

V. Phone/Fax

Practice location:
  • Phone: 570-620-4311
  • Fax: 570-620-4332
Mailing address:
  • Phone: 570-620-4311
  • Fax: 570-620-4332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC007007
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: