Individual provider Active NPI

Sophia C Nazzaro

  • Marriage & Family Therapist
  • Andover, MA
National Provider Identifier
1962857557
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
40 Shattuck Rd Ste 250
Andover, MA 01810-2492
Phone
(978) 222-3121
NPI assigned
May 2, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

40 Shattuck Rd Ste 250
Andover, MA 01810-2492

Mailing address

12 Fairfield St
Haverhill, MA 01832-4508
Phone (978) 609-1542

Other practice location 1

22 Old Canal Dr
Lowell, MA 01851-2730
Phone (978) 453-6800 ext. 5904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251223000160 MA Practitioner - Marriage and Family Therapist 2365937885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Behavioral Care of Connecticut PCGroup PAC ID 9436502879, 132 clinicians

Practice addresses (Care Compare)

40 Shattuck Rd
Suite 250
Andover, MA 01810-2492
Phone (978) 222-3121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Sep 21, 2025 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Sep 21, 2025 Accepting new patients
South Bay Mental Health Center, Inc. PastSince Sep 27, 2019 Accepting new patients
Family Counseling Associates of Salem Andover LLC Past Accepting new patients

Locations

40 Shattuck Rd
Ste 250
Andover, MA 01810
Phone (603) 505-6847

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1962857557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 FAIRFIELD ST",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018324508",
            "telephone_number": "978-609-1542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SHATTUCK RD STE 250",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018102492",
            "telephone_number": "978-222-3121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Old Canal Dr",
            "address_purpose": "LOCATION",
            "city": "Lowell",
            "state": "MA",
            "postal_code": "018512730",
            "country_code": "US",
            "telephone_number": "978-453-6800 x5904",
            "fax_number": "978-458-1428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAZZARO",
        "first_name": "SOPHIA",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-02",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MA

Sources for this page

Verify at the official NPI Registry.