Active NPI
Andrea Sue Zeren, PH.D.
- Psychologist
- Marblehead, MA
National Provider Identifier
1932290103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6628
- Practice address
- 2 Wyman Rd
Marblehead, MA 01945-3648 - Phone
- (978) 744-5006
- Fax
- (978) 241-7373
- NPI assigned
- Sep 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 6628 | MA | |
| Psychologist | 103T00000X | 6628 | MA | Primary |
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | 6628 | MA | |
| Marriage & Family Therapist | 106H00000X | 6628 | MA |
Addresses
Primary practice location
2 Wyman Rd
Marblehead, MA 01945-3648
Mailing address
2 Wyman Rd
Marblehead, MA 01945-3648
Phone (978) 744-5006
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W06485 | Other | MA | BCBSMA HEALTHCARE PROVIDE |
| 1896091 | Other | MA | MBHP HEALTH CARE PROVIDER |
| 494351 | Other | MA | TUFTS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6628 | MA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324857600000",
"number": "1932290103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 WYMAN RD",
"city": "MARBLEHEAD",
"state": "MA",
"postal_code": "019453648",
"telephone_number": "978-744-5006",
"fax_number": "978-241-7373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 WYMAN RD",
"city": "MARBLEHEAD",
"state": "MA",
"postal_code": "019453648",
"telephone_number": "978-744-5006",
"fax_number": "978-241-7373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZEREN",
"first_name": "ANDREA",
"middle_name": "SUE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-27",
"last_updated": "2011-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "MA",
"license": "6628",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "6628",
"primary": true
},
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "MA",
"license": "6628",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MA",
"license": "6628",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSMA HEALTHCARE PROVIDE",
"identifier": "W06485",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MBHP HEALTH CARE PROVIDER",
"identifier": "1896091",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "494351",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marblehead, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.