Provider Demographics
NPI:1881025963
Name:PAVLOVSKY, JAMES RAYMOND II (CAP, CADAC II)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RAYMOND
Last Name:PAVLOVSKY
Suffix:II
Gender:M
Credentials:CAP, CADAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 E TOWNE PL
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-3023
Mailing Address - Country:US
Mailing Address - Phone:321-631-4578
Mailing Address - Fax:321-631-1640
Practice Address - Street 1:7 N COCOA BLVD
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32922-7749
Practice Address - Country:US
Practice Address - Phone:321-631-4578
Practice Address - Fax:321-631-1640
Is Sole Proprietor?:No
Enumeration Date:2013-11-27
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)