Provider Demographics
NPI:1629070560
Name:OSGOOD, WENDY R (LMHC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:R
Last Name:OSGOOD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 STATE ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-6621
Mailing Address - Country:US
Mailing Address - Phone:978-462-2890
Mailing Address - Fax:978-462-2890
Practice Address - Street 1:160 SUMMER ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6318
Practice Address - Country:US
Practice Address - Phone:978-462-2890
Practice Address - Fax:978-462-2890
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4819101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALM0852OtherBLUE CROSS BLUE SHIELD