Provider Demographics
NPI:1124493010
Name:MEDRANO, ANDREA (LMHC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:MEDRANO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:LEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22 BANKS ST
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:MA
Mailing Address - Zip Code:02152-1904
Mailing Address - Country:US
Mailing Address - Phone:845-662-9169
Mailing Address - Fax:
Practice Address - Street 1:301 BROADWAY
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-2807
Practice Address - Country:US
Practice Address - Phone:617-889-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-03
Last Update Date:2023-03-21
Deactivation Date:2023-02-03
Deactivation Code:
Reactivation Date:2023-03-21
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health