Provider Demographics
NPI:1649755992
Name:FISCHER, ANDREA ROSE
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:ROSE
Last Name:FISCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1434
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MA
Mailing Address - Zip Code:01083-1434
Mailing Address - Country:US
Mailing Address - Phone:413-045-0004
Mailing Address - Fax:413-450-0294
Practice Address - Street 1:175 DWIGHT RD
Practice Address - Street 2:
Practice Address - City:LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01106-1576
Practice Address - Country:US
Practice Address - Phone:413-450-0004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1246111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical