Provider Demographics
NPI:1164793980
Name:KERHOULAS, ANDREW STEVEN
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:STEVEN
Last Name:KERHOULAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 ESSEX STREET
Mailing Address - Street 2:
Mailing Address - City:SOUTH HAMILTON
Mailing Address - State:MA
Mailing Address - Zip Code:01982
Mailing Address - Country:US
Mailing Address - Phone:828-421-3360
Mailing Address - Fax:
Practice Address - Street 1:130 ESSEX ST
Practice Address - Street 2:
Practice Address - City:SOUTH HAMILTON
Practice Address - State:MA
Practice Address - Zip Code:01982-2325
Practice Address - Country:US
Practice Address - Phone:828-421-3360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor