Provider Demographics
NPI:1235928920
Name:SPINNEY, NATHAN MILES (LADC II)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:MILES
Last Name:SPINNEY
Suffix:
Gender:
Credentials:LADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-8142
Mailing Address - Country:US
Mailing Address - Phone:978-343-6300
Mailing Address - Fax:978-343-2803
Practice Address - Street 1:324 PLEASANT ST # 5
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-2900
Practice Address - Country:US
Practice Address - Phone:978-343-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21600101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)