Healthcare Provider Details

I. General information

NPI: 1447860036
Provider Name (Legal Business Name): ANDREA KREMER LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2020
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 LEXINGTON ST WALTHAM PLAZA #1047
WALTHAM MA
02451
US

IV. Provider business mailing address

800 LEXINGTON ST WALTHAM PLAZA #1047
WALTHAM MA
02452-4848
US

V. Phone/Fax

Practice location:
  • Phone: 781-214-4412
  • Fax:
Mailing address:
  • Phone: 857-228-8686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number10000030
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10000333
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCC8443
License Number StateME
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number100.0134582TELE
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: