Provider Demographics
NPI:1255815585
Name:KRAUSE, ANDREA CAPORRELLA (LICSW, CEAP)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:CAPORRELLA
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:LICSW, CEAP
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:MARIE
Other - Last Name:CAPORRELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW, CEAP
Mailing Address - Street 1:124 BLUEBERRY HILL LN
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5304
Mailing Address - Country:US
Mailing Address - Phone:617-852-9891
Mailing Address - Fax:
Practice Address - Street 1:124 BLUEBERRY HILL LN
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5304
Practice Address - Country:US
Practice Address - Phone:617-852-9891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1104061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical