Provider Demographics
NPI:1679620389
Name:HAHN, ANDREW (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:HAHN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 WORCESTER LN
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-7538
Mailing Address - Country:US
Mailing Address - Phone:781-891-7448
Mailing Address - Fax:
Practice Address - Street 1:115 WORCESTER LN
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-7538
Practice Address - Country:US
Practice Address - Phone:781-274-6633
Practice Address - Fax:781-274-6644
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPY4357-PR103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA142390OtherMAGELLAN BEHAVIORAL HEALT
MA008775OtherVALUE OPTIONS
MAW04346OtherBLUE CROSS BLUE SHIELD