Active NPI
Theresa Marie Goodwin Banzhaf, M. ED.
- Developmental Therapist
- Merrimac, MA
National Provider Identifier
1457773665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- License
- DESE 445692
- Practice address
- 13 Summer St
Merrimac, MA 01860-1430 - Phone
- (978) 852-3783
- NPI assigned
- Jan 8, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | DESE 445692 | MA | Primary |
Addresses
Primary practice location
13 Summer St
Merrimac, MA 01860-1430
Mailing address
13 Summer St
Merrimac, MA 01860-1430
Phone (978) 852-3783
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DESE 445692 | MA | MD | Developmental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389139200000",
"number": "1457773665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 SUMMER ST",
"city": "MERRIMAC",
"state": "MA",
"postal_code": "018601430",
"telephone_number": "978-852-3783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13 SUMMER ST",
"city": "MERRIMAC",
"state": "MA",
"postal_code": "018601430",
"telephone_number": "978-852-3783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANZHAF",
"first_name": "THERESA",
"middle_name": "MARIE GOODWIN",
"name_prefix": "Mrs.",
"credential": "M. ED.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-08",
"last_updated": "2014-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "MA",
"license": "DESE 445692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merrimac, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.