ELIJAH TYLER ANDRADE
NPI 1427737147
Counselor - Mental Health in Brockton, MA
Active since July 12, 2023
About Elijah Tyler Andrade NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ELIJAH TYLER ANDRADE (NPI 1427737147) is an individual mental health provider in Brockton, Massachusetts and active in the NPI registry since July 2023.
NPPES Registry Identity
NPI1427737147
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameELIJAH TYLER ANDRADE
Location Address30 OAK ST EXT APT 107Brockton, MA 02301-1161
Mailing Address54 N Main StBrockton, MA 02301-3907 · (508) 587-5441
Phone(404) 820-3015
Sole ProprietorNo
Enumeration DateJuly 12, 2023
NPPES CertifiedJuly 12, 2023
✔ NPI 1427737147 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
30 OAK ST EXT APT 107, Brockton, MA 02301
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1427737147, enumerated as an "individual" on July 12, 2023.
The provider is located at 30 OAK ST EXT APT 107 BROCKTON, MA 02301 and the phone number is (404) 820-3015.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
