Provider Demographics
NPI:1336281070
Name:ANDOVER MENTAL HEALTH ASSOCIATES, LLC
Entity Type:Organization
Organization Name:ANDOVER MENTAL HEALTH ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RNCSPC
Authorized Official - Phone:978-470-0520
Mailing Address - Street 1:1 ELM SQ
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-3643
Mailing Address - Country:US
Mailing Address - Phone:978-470-0520
Mailing Address - Fax:
Practice Address - Street 1:1 ELM SQ
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3643
Practice Address - Country:US
Practice Address - Phone:978-470-0520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty