Provider Demographics
NPI:1043580053
Name:PASTORELLO, ANDREA SUSAN (LMHC)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:SUSAN
Last Name:PASTORELLO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 SW 57TH AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5528
Mailing Address - Country:US
Mailing Address - Phone:305-202-1347
Mailing Address - Fax:305-238-3511
Practice Address - Street 1:7800 SW 57TH AVE
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5528
Practice Address - Country:US
Practice Address - Phone:305-202-1347
Practice Address - Fax:305-238-3511
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8496101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health