Provider Demographics
NPI:1417223462
Name:CALLAHAN, ANDREA LEE (MSHS- COMMUNITY PSYC)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:LEE
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:MSHS- COMMUNITY PSYC
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:LEE
Other - Last Name:CALLAHAN-WAGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSHS- COMMUNITY PSYC
Mailing Address - Street 1:131 WEST MAIN STREET
Mailing Address - Street 2:CHD-FIRST FLOOR
Mailing Address - City:ORANGE
Mailing Address - State:MA
Mailing Address - Zip Code:01364
Mailing Address - Country:US
Mailing Address - Phone:978-544-2148
Mailing Address - Fax:978-544-2196
Practice Address - Street 1:131 WEST MAIN STREET
Practice Address - Street 2:CHD-FIRST FLOOR
Practice Address - City:ORANGE
Practice Address - State:MA
Practice Address - Zip Code:01364
Practice Address - Country:US
Practice Address - Phone:978-544-2148
Practice Address - Fax:978-544-2196
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor