Provider Demographics
NPI:1184640039
Name:BARNES, ANDREA (PHD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 401
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-0007
Mailing Address - Country:US
Mailing Address - Phone:781-854-6724
Mailing Address - Fax:781-331-2901
Practice Address - Street 1:37 DERBY ST
Practice Address - Street 2:SUITE 1
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-3741
Practice Address - Country:US
Practice Address - Phone:781-854-6724
Practice Address - Fax:781-331-2901
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6009103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical