National Provider Identifier

Andrew John Park, MAMHC

Andrew John Park, MAMHC is listed in the NPPES registry with a primary specialty of Counselor in Canandaigua, NY and a listed phone number of (585) 396-4190.

NPI 1386975399Canandaigua, NYCounselor

Profile Overview

NPI
1386975399
Provider Type
Individual
Primary Specialty
Counselor
Enumeration Date
January 15, 2010
Last Updated
January 15, 2010

Practice Location

  • 3019 County Complex Dr.
  • Canandaigua, NY 14424

Phone: (585) 396-4190

Mailing Address

  • 3019 County Complex Dr
  • Canandaigua, NY 14424-9505

Specialties

  • Counselor (101Y00000X)
Full Record
NPI
1386975399
Entity Type
Individual
Last Name
Park
First Name
Andrew
Middle Name
John
Name Prefix
Mr.
Credential
MAMHC
Mailing Street Address
3019 County Complex Dr
Mailing City
Canandaigua
Mailing State
NY
Mailing ZIP Code
14424-9505
Mailing Country
US
Mailing Phone
(585) 396-4190
Mailing Fax
(585) 383-2916
Practice Street Address
3019 County Complex Dr.
Practice City
Canandaigua
Practice State
NY
Practice ZIP Code
14424
Practice Country
US
Practice Phone
(585) 396-4190
Practice Fax
(585) 393-2916
Enumeration Date
January 15, 2010
Last Updated
January 15, 2010
Sex
Male
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Counselor (101Y00000X)