Healthcare Provider Details

I. General information

NPI: 1568157832
Provider Name (Legal Business Name): ERICA MAZZONE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 HIGH ST
NORTH ANDOVER MA
01845-2620
US

IV. Provider business mailing address

42 WALDEMAR AVE
WINTHROP MA
02152-2334
US

V. Phone/Fax

Practice location:
  • Phone: 978-975-3355
  • Fax:
Mailing address:
  • Phone: 617-953-7515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY10002170
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: