Provider Demographics
NPI:1154804961
Name:KAMINS, ANDREA JULIE (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:JULIE
Last Name:KAMINS
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1295 BEACON ST # 1053
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-9998
Mailing Address - Country:US
Mailing Address - Phone:617-545-4237
Mailing Address - Fax:
Practice Address - Street 1:1310 BEACON ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-3701
Practice Address - Country:US
Practice Address - Phone:617-545-4237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-09
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223825104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker