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NPI 1548089386

NPI 1548089386 : ANDREA KIOTIS LPC, CAADC : PHOENIXVILLE, PA

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General NPI Number Information
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    NPI Number           |    1548089386
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    Entity Type          |    Individual 
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    Provider Name        |    ANDREA KIOTIS LPC, CAADC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/08/2024
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    Last Update Date     |    10/08/2024
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Provider Practice Location Address
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    Address Line         |    710 WHEATLAND ST 
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    City                 |    PHOENIXVILLE
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    State                |    PA
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    Zip                  |    19460-3988
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    Country              |    US
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    Telephone            |    484-802-7494
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    18 LOCUST FARM DR 
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    City                 |    THORNTON
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    State                |    PA
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    Zip                  |    19373-1000
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    Country              |    US
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    Telephone            |    484-802-7494
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    PC015632
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    License Number State |    PA
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Taxonomy #2
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    
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    License Number State |    
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