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General NPI Number Information
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NPI Number | 1003700758
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Entity Type | Organization
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Legal Business Name | ANDOVER PSYCHOTHERAPY
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Dates
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Enumeration Date | 06/06/2025
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 35 VILLAGE ROAD SUITE 100
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City | MIDDLETON
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State | MA
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Zip | 01949
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Country | US
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Telephone | 339-234-9528
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Fax |
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Provider Business Mailing Address
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Address Line | 73 TURNPIKE ST # 1161
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City | NORTH ANDOVER
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State | MA
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Zip | 01845-5045
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LAURA GOODRIDGE
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Credential | LICSW
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Telephone | 399-234-9528
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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