NPI Code Detail JSON Logo

1164613402 NPI number — ANDREA MARIE HOLLERAN LICSW

NPI Number: 1164613402
Health Care Provider/Practitioner: ANDREA MARIE HOLLERAN LICSW

Information about “1164613402” NPI (ANDREA MARIE HOLLERAN LICSW) exists in 1164613402 in HTML format HTML  |  1164613402 in plain Text format TXT  |  1164613402 in PDF (Portable Document Format) PDF  |  1164613402 in an XML format XML  formats.

NPI Number : 1164613402 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1164613402",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HOLLERAN",
    "FirstName": "ANDREA",
    "MiddleName": "MARIE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "LICSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "LOPRESTI",
    "OtherFirstName": "ANDREA",
    "OtherMiddleName": "MARIE",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "LICSW",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "BEACON HEALTH OPTIONS",
    "SecondLineMailingAddress": "500 UNICORN PARK DRIVE",
    "MailingAddressCityName": "WOBURN",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "01801",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "570-335-9912",
    "MailingAddressFaxNumber": "781-994-7668",
    "FirstLinePracticeLocationAddress": "BEACON HEALTH OPTIONS",
    "SecondLinePracticeLocationAddress": "500 UNICORN PARK DRIVE",
    "PracticeLocationAddressCityName": "WOBURN",
    "PracticeLocationAddressStateName": "MA",
    "PracticeLocationAddressPostalCode": "01801",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "570-335-9912",
    "PracticeLocationAddressFaxNumber": "781-994-7668",
    "EnumerationDate": "08/01/2007",
    "LastUpdateDate": "03/14/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "390200000X",
        "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.