NPIMap

Organization Active NPI

Endeavor Psychology and Consulting LLC

  • Psychologist
  • Marblehead, MA
National Provider Identifier
1750917506
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
ENDEAVOR PSYCHOLOGY AND CONSULTING LLC
Practice address
12 Spring St
Marblehead, MA 01945-3314
Phone
(617) 207-4124
NPI assigned
Mar 12, 2020
Last updated
Mar 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Authorized official

Name
Dr. Brad Spickard, PHDNPI 1003166323
Title
Owner
Phone
(617) 207-4124

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

12 Spring St
Marblehead, MA 01945-3314

Mailing address

71 Walker Rd
Swampscott, MA 01907-2054
Phone (617) 817-8513

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1583971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583971200000",
    "number": "1750917506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 WALKER RD",
            "city": "SWAMPSCOTT",
            "state": "MA",
            "postal_code": "019072054",
            "telephone_number": "617-817-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 SPRING ST",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019453314",
            "telephone_number": "617-207-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDEAVOR PSYCHOLOGY AND CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-12",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A",
        "authorized_official_last_name": "SPICKARD",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-207-4124",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marblehead, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; 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.