NPIMap

Organization Active NPI

North Shore Neuropsychological Services, LLC

  • Clinical Neuropsychologist
  • Peabody, MA
National Provider Identifier
1205110822
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
8883 Issued in MA
Legal business name
NORTH SHORE NEUROPSYCHOLOGICAL SERVICES, LLC
Practice address
5 Essex Green Drive
Suite 23
Peabody, MA 01960
Phone
(857) 383-0651
Fax
(781) 990-3722
NPI assigned
Sep 30, 2011
Last updated
Oct 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Courtney Lobraico, PSYDNPI 1558526376
Title
Clinical Neuropsychologist
Phone
(857) 383-0651

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 8883 MA Primary

Addresses

Primary practice location

5 Essex Green Drive
Suite 23
Peabody, MA 01960

Mailing address

5 Essex Green Drive
Suite 23
Peabody, MA 01960
Phone (857) 383-0651

National Provider Directory

National Provider Directory

Locations

5 Essex Green Dr
Ste 23
Peabody, MA 01960
Phone (857) 383-0651

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1205110822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ESSEX GREEN DRIVE",
            "address_2": "SUITE 23",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "01960",
            "telephone_number": "857-383-0651",
            "fax_number": "781-990-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 ESSEX GREEN DRIVE",
            "address_2": "SUITE 23",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "01960",
            "telephone_number": "857-383-0651",
            "fax_number": "781-990-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE NEUROPSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-30",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "LOBRAICO",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "CLINICAL NEUROPSYCHOLOGIST",
        "authorized_official_telephone_number": "857-383-0651",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "8883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.