KIMBERLY ETHRIDGE FITZGIBBON (NPI# 1255945135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255945135 |
| Entity Type | Individual |
| Full Name | KIMBERLY ETHRIDGE FITZGIBBON |
| Credential | PHD |
| Practice Address |
26 Chestnut St Ste 2e Andover MA 01810-3600 |
| Mailing Address |
39 Centre St Dover MA 02030-2205 |
| Practice Telephone | 9787492700 |
| Mailing Telephone | 6176458745 |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2020-09-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers |
| Street Address |
26 CHESTNUT ST STE 2E |
| City | ANDOVER |
| State | MA |
| Zip Code | 01810-3600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881102515 | Matthew S Conway | Clinical Neuropsychologist | 26 Chestnut St Ste 2e, Andover, MA 01810-3600 | 2018-01-16 |
| 1689275687 | Ramya Rangamannar | Psychologist | 26 Chestnut St Ste 2e, Andover, MA 01810-3600 | 2020-11-05 |
| 1104424407 | Kathryn R Bradbury | Psychologist | 26 Chestnut St Ste 2e, Andover, MA 01810-3600 | 2020-10-09 |
| 1093273997 | Meghan Therese Lee | Clinical Neuropsychologist | 26 Chestnut St Ste 2e, Andover, MA 01810-3600 | 2019-03-10 |
| 1417415563 | Ilana Reife | Clinical Neuropsychologist | 26 Chestnut St Ste 2e, Andover, MA 01810-3600 | 2019-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871123513 | Jill Katherine Priestley | Registered Nurse | 251 South Main Street, Andover, MA 01810 | 2020-01-22 |
| 1023672086 | Diane Marie Gallant | Occupational Therapy Assistant | 5606 80 Andover Street, Andover, MA 01810 | 2019-04-25 |
| 1932677473 | Jessica Howie | Physician Assistant | 28 Andover St Fl 1, Andover, MA 01810 | 2018-11-02 |
| 1972087138 | Mia Cloonan | Social Worker | 1 Punchard Avenue, Apt. 3 Rear, Andover, MA 01810 | 2018-09-23 |
| 1063995462 | Janet Suleski | Social Worker | 10 Stevens St, Andover, MA 01810 | 2018-09-11 |
| 1942794706 | Alison Catherine Lynch | Optometrist | 7 Parthenon Cir, Andover, MA 01810 | 2018-06-15 |
| 1740773647 | Wandajune Bishop-towle | Psychologist | 75 Wild Rose Dr., Andover, MA 01810 | 2018-06-14 |
| 1235689860 | Jo-ann Elizabeth Newcomb | Registered Nurse | 12 Hemlock Rd, Andover, MA 01810 | 2016-10-06 |
| 1922476712 | Marianela Rivera | Physical Therapist | 32 Osgood St., Andover, MA 01810 | 2015-09-10 |
| 1447535935 | Kathleen L Mccracken | Occupational Therapy Assistant | 200 Brickstone Square, 3rd Floor, Genesis Rehab Services, Andover, MA 01810 | 2011-10-15 |
| Find all providers in zip 01810 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881102515 | Matthew S Conway | Clinical Neuropsychologist | 26 Chestnut St Ste 2e, Andover, MA 01810-3600 | 2018-01-16 |
| 1295771533 | Pamela Grace Devaney | Clinical Neuropsychologist | 63 Park St, Suite 15, Andover, MA 01810-3662 | 2006-06-22 |
| 1093273997 | Meghan Therese Lee | Clinical Neuropsychologist | 26 Chestnut St Ste 2e, Andover, MA 01810-3600 | 2019-03-10 |
| 1417415563 | Ilana Reife | Clinical Neuropsychologist | 26 Chestnut St Ste 2e, Andover, MA 01810-3600 | 2019-03-07 |
| 1578927737 | Neuropsychology Consultants, Inc | Clinical Neuropsychologist | 166 N Main St, Suite 3b, Andover, MA 01810-6504 | 2016-04-13 |
| 1053477463 | Karen Spangenberg Postal | Clinical Neuropsychologist | 166 N Main St, Suite 3b, Andover, MA 01810-6504 | 2006-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949873 | Erica Rose Appleman | Clinical Neuropsychologist | 134 Horace St, Boston, MA 02128-1581 | 2020-07-09 |
| 1578187613 | Nancy Schneider-pruett | Clinical Neuropsychologist | The Neuropsychology Service, 100 Cummings Center, Beverly, MA 01982 | 2020-06-04 |
| 1194365312 | Erin Grace Kitchener | Clinical Neuropsychologist | 1 Wells Ave Fl 4, Newton, MA 02459-3211 | 2020-01-15 |
| 1407330509 | Coastal Psychological Center, LLC. | Clinical Neuropsychologist | 36 Woburn St Ste 6, Reading, MA 01867-2903 | 2018-09-24 |
| 1811415326 | Francesca Lavecchia | Clinical Neuropsychologist | Brockto Area Multi Service, Inc. 10 Christy Dr., Brockton, MA 02301 | 2017-09-05 |
| 1346792637 | Margaret Alice Mcphee | Clinical Neuropsychologist | 29 Regina Dr, Chelmsford, MA 01824-4540 | 2016-11-02 |
| 1154870814 | Jessica Pan | Clinical Neuropsychologist | 1 Bowdoin St, 7th Floor, Boston, MA 02114-4201 | 2016-09-22 |
| 1508217506 | Donald Bearden | Clinical Neuropsychologist | 30 Iroquois St, Unit 33, Roxbury Crossing, MA 02120-2848 | 2016-06-30 |
| 1497115612 | Susan Magocsi | Clinical Neuropsychologist | 13 Meetinghouse Ln, Milton, MA 02186-2415 | 2016-03-01 |
| 1033524913 | Grant Loren Iverson | Clinical Neuropsychologist | Home Base Program, 101 Merrimac Street, 2nd Floor, Boston, MA 02114 | 2014-06-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.