Healthcare Provider Details

I. General information

NPI: 1366829400
Provider Name (Legal Business Name): MICHAEL STEVEN PANZA M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2015
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 TURNPIKE ST # 1194
NORTH ANDOVER MA
01845-5045
US

IV. Provider business mailing address

73 TURNPIKE ST # 1194
NORTH ANDOVER MA
01845-5045
US

V. Phone/Fax

Practice location:
  • Phone: 978-225-3201
  • Fax:
Mailing address:
  • Phone: 978-225-3201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11002
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: