MEDICARE: ANDREA GARVEY M.S. ABA, BCBA, LABA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	LABA10000684	MA
2	103K00000X	Behavior Analyst	146.0134354	VT

General Provider Information

NPI Number	:	1821850199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA GARVEY M.S. ABA, BCBA, LABA

Provider Business Mailing Address
First Line	:	27 HEMENWAY RD APT B
Second Line	:
City	:	LEVERETT
State	:	MA
Zip	:	01054-9738
Country	:	US
Telephone Number	:	413-658-7725
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 PAPINEAU ST
Second Line	:
City	:	HOLYOKE
State	:	MA
Zip	:	01040-3417
Country	:	US
Telephone Number	:	413-262-3721
Fax Number	:	413-507-3363

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2024
Last Update Date	:	10/31/2024

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