Provider Demographics
NPI:1447869128
Name:ROGERS, ANDREA HARTMANN (LMHC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:HARTMANN
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:DAWN
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:64 ELDREDGE ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-2017
Mailing Address - Country:US
Mailing Address - Phone:617-969-4925
Mailing Address - Fax:
Practice Address - Street 1:64 ELDREDGE STREET
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-2017
Practice Address - Country:US
Practice Address - Phone:617-969-4925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2024-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC10001738101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health