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NPI Code Detail

MEDICARE: ANDREA DAWYDOWYCZ LPC

MEDICARE: ANDREA DAWYDOWYCZ LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor8714-125WI

General Provider Information

NPI Number : 1922783547
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA DAWYDOWYCZ LPC
Provider Business Mailing Address
First Line : 2515 S 88TH ST
Second Line :
City : WEST ALLIS
State : WI
Zip : 53227-2723
Country : US
Telephone Number : 414-630-1258
Fax Number :
Provider Business Practice Location Address
First Line : 10850 W PARK PL STE 100
Second Line :
City : MILWAUKEE
State : WI
Zip : 53224-3636
Country : US
Telephone Number : 262-999-3495
Fax Number : 262-821-6180
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2023
Last Update Date : 05/28/2026

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