Provider Demographics
NPI:1992019533
Name:LINDSAY-KELLEY, ANDREA (MSW, MPH, LICSW)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:LINDSAY-KELLEY
Suffix:
Gender:F
Credentials:MSW, MPH, LICSW
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:KELLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:275 CURVE ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02324-3418
Mailing Address - Country:US
Mailing Address - Phone:508-484-5935
Mailing Address - Fax:617-328-1635
Practice Address - Street 1:10 GRANITE ST FL 3
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5021
Practice Address - Country:US
Practice Address - Phone:508-484-5935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MA1205131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor