Provider Demographics
NPI:1467580175
Name:MAITINSKY KEINS, ANDREA (PHD PSYCHOLOGIST)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:MAITINSKY KEINS
Suffix:
Gender:F
Credentials:PHD PSYCHOLOGIST
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:KEINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD PSYCHOLOGIST
Mailing Address - Street 1:PO BOX 9627
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01059-9627
Mailing Address - Country:US
Mailing Address - Phone:413-237-0086
Mailing Address - Fax:
Practice Address - Street 1:274 N PLEASANT ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-1725
Practice Address - Country:US
Practice Address - Phone:413-237-0086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1300881Medicaid
MA0300050OtherMBHP