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General NPI Number Information
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NPI Number | 1669192498
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Entity Type | Individual
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Provider Name | NIKKI LEIGH ANDRUSCAVAGE LPC
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Gender | Female
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Dates
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Enumeration Date | 08/31/2022
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Last Update Date | 08/31/2022
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Provider Practice Location Address
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Address Line | 353 W MAIN ST
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City | LEOLA
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State | PA
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Zip | 17540-2107
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Country | US
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Telephone | 717-827-7253
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Fax |
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Provider Business Mailing Address
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Address Line | 682 WALLINGFORD RD APT 106
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City | LITITZ
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State | PA
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Zip | 17543-8252
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Country | US
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Telephone |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | PC014844
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License Number State | PA
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