Healthcare Provider Details

I. General information

NPI: 1942110606
Provider Name (Legal Business Name): ANDREW J HERD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DREW HERD

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 ELDREDGE ST
NEWTON MA
02458-2017
US

IV. Provider business mailing address

64 ELDREDGE ST
NEWTON MA
02458-2017
US

V. Phone/Fax

Practice location:
  • Phone: 617-969-4925
  • Fax: 617-552-7676
Mailing address:
  • Phone: 617-969-4925
  • Fax: 617-552-7676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: