DR. FREDERICK W. PENZA ED.D. NPI 1720143381

NPI Information

NPI: 1720143381
Provider Name: DR. FREDERICK W. PENZA, ED.D.
Classification: Psychologist - 103TH0100X
Specialization: Health Service
Entity Type: Individual
Address: 6 ENFIELD DR
ANDOVER, MA
ZIP 01810
Phone: (978) 475-6169

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NPI Details

DR. Frederick W. Penza, ED.D. is a health service psychologist in Andover, MA. The provider is a psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). DR. Frederick W. Penza, ED.D. NPI is 1720143381. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6 ENFIELD DR
ANDOVER, MA
ZIP 01810-021
Phone: (978) 475-6169

The enumeration date for this NPI number is 12/26/2006 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TH0100X	Psychologist	Health Service	871	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0505366	MEDICAID	MASSACHUSETTS
2	WO1265	MEDICARE ID-TYPE UNSPECIFIED	MASSACHUSETTS	MEDICARE PROVIDER NUMBER
3	WO1265	OTHER	MASSACHUSETTS	BCBS PROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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