Provider Demographics
NPI:1730932377
Name:ANDY NOVINSKA, LCPC, PLLC
Entity type:Organization
Organization Name:ANDY NOVINSKA, LCPC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVINSKA
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:309-660-2900
Mailing Address - Street 1:601 E MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:MAHOMET
Mailing Address - State:IL
Mailing Address - Zip Code:61853-7461
Mailing Address - Country:US
Mailing Address - Phone:309-660-2900
Mailing Address - Fax:
Practice Address - Street 1:601 E MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:MAHOMET
Practice Address - State:IL
Practice Address - Zip Code:61853-7461
Practice Address - Country:US
Practice Address - Phone:309-660-2900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty