Provider Demographics
NPI:1730658824
Name:NOVAK, DAVID S (MSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:NOVAK
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 ALBATROSS RD
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-2601
Mailing Address - Country:US
Mailing Address - Phone:617-543-3283
Mailing Address - Fax:
Practice Address - Street 1:81 ALBATROSS RD
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-2601
Practice Address - Country:US
Practice Address - Phone:617-543-3283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10274021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical