Provider Demographics
NPI:1811213580
Name:ANDREOTTOLA, ANTHONY (LMHC)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:ANDREOTTOLA
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 HUNTINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-4605
Mailing Address - Country:US
Mailing Address - Phone:617-266-7040
Mailing Address - Fax:617-366-8042
Practice Address - Street 1:270 HUNTINGTON AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-4605
Practice Address - Country:US
Practice Address - Phone:617-266-7040
Practice Address - Fax:617-366-8042
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4193101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health