Provider Demographics
NPI:1083082333
Name:KERR, ANDREA (MHC)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:KERR
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 ROUTE 216
Mailing Address - Street 2:APT 1
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-4337
Mailing Address - Country:US
Mailing Address - Phone:845-800-5468
Mailing Address - Fax:
Practice Address - Street 1:15 MOUNT CARMEL PL
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1714
Practice Address - Country:US
Practice Address - Phone:845-485-8901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP99249101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health