Provider Demographics
NPI:1003700758
Name:ANDOVER PSYCHOTHERAPY
Entity type:Organization
Organization Name:ANDOVER PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:399-234-9528
Mailing Address - Street 1:73 TURNPIKE ST # 1161
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5045
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:35 VILLAGE ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:MIDDLETON
Practice Address - State:MA
Practice Address - Zip Code:01949
Practice Address - Country:US
Practice Address - Phone:339-234-9528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty