Provider Demographics
NPI:1164613402
Name:HOLLERAN, ANDREA MARIE (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:MARIE
Last Name:HOLLERAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:MARIE
Other - Last Name:LOPRESTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:BEACON HEALTH OPTIONS
Mailing Address - Street 2:500 UNICORN PARK DRIVE
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801
Mailing Address - Country:US
Mailing Address - Phone:570-335-9912
Mailing Address - Fax:781-994-7668
Practice Address - Street 1:BEACON HEALTH OPTIONS
Practice Address - Street 2:500 UNICORN PARK DRIVE
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801
Practice Address - Country:US
Practice Address - Phone:570-335-9912
Practice Address - Fax:781-994-7668
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program