Provider Demographics
NPI:1346320009
Name:LAVOIE, PAULA J (MSW LICSW)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:J
Last Name:LAVOIE
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 WASHINGTON ST
Mailing Address - Street 2:SUITE 301E
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820
Mailing Address - Country:US
Mailing Address - Phone:603-742-4157
Mailing Address - Fax:
Practice Address - Street 1:90 WASHINGTON ST
Practice Address - Street 2:SUITE 301E
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820
Practice Address - Country:US
Practice Address - Phone:603-742-4157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NH8401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30421174Medicaid
NH1405433Y0NH01OtherANTHEM PAULA LAVOIE
NH394711OtherMAGELLAN
NH394711OtherMAGELLAN