Provider Demographics
NPI:1871293605
Name:LODICO, ANDREA (PHD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:LODICO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3122
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-8003
Mailing Address - Country:US
Mailing Address - Phone:917-370-5991
Mailing Address - Fax:
Practice Address - Street 1:229 WASHINGTON ST STE 304
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-5947
Practice Address - Country:US
Practice Address - Phone:518-430-2068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025601103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical