Provider Demographics
NPI:1407910698
Name:ANDREAZI, PERCY FERNANDO (LMHC)
Entity Type:Individual
Prefix:
First Name:PERCY
Middle Name:FERNANDO
Last Name:ANDREAZI
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 VILLAGE HILL LN APT 5
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-5723
Mailing Address - Country:US
Mailing Address - Phone:617-206-0167
Mailing Address - Fax:617-544-0622
Practice Address - Street 1:1 VILLAGE HILL LN APT 5
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-5723
Practice Address - Country:US
Practice Address - Phone:617-206-0167
Practice Address - Fax:617-544-0622
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6676101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health