Provider Demographics
NPI:1437206612
Name:NORKUS, ANDREA G (EDD)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:G
Last Name:NORKUS
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 LEE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-5900
Mailing Address - Country:US
Mailing Address - Phone:617-731-1186
Mailing Address - Fax:617-731-4717
Practice Address - Street 1:581 BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-3608
Practice Address - Country:US
Practice Address - Phone:617-236-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2222103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist