Provider Demographics
NPI:1689721391
Name:BLEICHMAR, ANDREA PAULA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:PAULA
Last Name:BLEICHMAR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 BEACON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-4819
Mailing Address - Country:US
Mailing Address - Phone:617-538-1414
Mailing Address - Fax:
Practice Address - Street 1:1415 BEACON ST STE 200
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-4819
Practice Address - Country:US
Practice Address - Phone:617-538-1414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA310307103T00000X
MA7695103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist