Healthcare Provider Details

I. General information

NPI: 1366150625
Provider Name (Legal Business Name): ANDREW CHARLES FIERIMONTE M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 HOPE AVE # 312
WALTHAM MA
02453-2721
US

IV. Provider business mailing address

88 MAIN ST APT A
NORTHBOROUGH MA
01532-1936
US

V. Phone/Fax

Practice location:
  • Phone: 617-918-7484
  • Fax:
Mailing address:
  • Phone: 774-258-1374
  • Fax:

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: