Basic Information
| Provider Information | |||||||||
| NPI: | 1366150625 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FIERIMONTE | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | CHARLES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 88 MAIN ST APT A | ||||||||
| Address2: | |||||||||
| City: | NORTHBOROUGH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 015321936 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7742581374 | ||||||||
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| Practice Location | |||||||||
| Address1: | 324 CLARK ST | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016061214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5087914976 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2022 | ||||||||
| LastUpdateDate: | 11/07/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.