Organization
FANNTHERA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY ALDRICH LICSW (CLINICAL SOCIAL WORKER)
(978) 837-4914
Entity
Organization
Contact information
Practice address
177 MASSACHUSETTS AVE APT 1, NORTH ANDOVER, MA 01845-4139
(978) 387-4914
Mailing address
177 MASSACHUSETTS AVE APT 1, NORTH ANDOVER, MA 01845-4139
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
11/17/2022
Last updated
11/17/2022
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