Otniela Andrade
Individual provider Active NPI Mental Health Counselor · Lexington, MA
NPI 1194014811 · NPPES record last updated Apr 4, 2011
Key facts
- NPI
- 1194014811
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 1040 Waltham St
Lexington, MA 02421-8033 - Phone
- (781) 862-3600
- Fax
- (781) 860-0589
- NPI assigned
- Apr 4, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Edinburg Center Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
1040 Waltham St
Lexington, MA 02421-8033
Mailing address
1040 Waltham St
Lexington, MA 02421-8033
Phone (781) 862-3600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000023532 | Other | MA | BMC |
| 1303287 | Other | MA | MBHP |
| M18633 | Other | MA | BCBS |
| 1004745 | Other | MA | NHP |
| 042611055 | Other | MA | TAX ID |
| 99618201 | Other | MA | NETWORK HEALTH |
| 1303287 | Medicaid | MA |
Other providers in Lexington, MA
- Cynthia Peabody Anderson
- Katelyn Kim Anderson
- Mark Anderson
- Samuel Joseph Andonian
- Silva Andonyan
- Sarah Andreozzi
- Thomas E Andrews
- Lisa Pagliaro Andrianopoulos
- Jaelyn Angelo
- Lois Angelo
All providers in Lexington, MA · Mental Health Counselor in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.