Eating Disorder Center of Andover, LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1383 Issued in MA

Legal business name

EATING DISORDER CENTER OF ANDOVER, LLC

Practice address

68 Main St
5
Andover, MA 01810-3846

Phone

(978) 475-1617

Fax

(978) 824-9600

NPI assigned

Oct 7, 2011

Organization subpart

No

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

Authorized official

Name

Karin Lewis, LMFT

Title

Clinical Director

Phone

(978) 475-1617

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317945600000",
    "number": "1962786004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 MAIN ST",
            "address_2": "5",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 MAIN ST",
            "address_2": "5",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103846",
            "telephone_number": "978-475-1617",
            "fax_number": "978-824-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EATING DISORDER CENTER OF ANDOVER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-07",
        "last_updated": "2011-10-07",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "KARIN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "978-475-1617",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "MA",
            "license": "1383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebekah Margaret Dunklee, M.S.ED.,CCLS,CEIS
• Kathleen Durland, OTR
• Adrienne Dussault, LICSW
• Bradley T Eardley, MA, LMFT
• Barbara Earing
• Maria S Eaton, LMHC
• Laura Eberth, RN
• Ecp Family Counseling
• Beth Edelstein, LMHC
• Lori S Edwards, LICSW

• Marriage & Family Therapist in Andover, MA
• Providers in Andover, MA by specialty
• Marriage & Family Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.