Provider Demographics
NPI:1992827281
Name:NIV, NAVA (MSW)
Entity Type:Individual
Prefix:MS
First Name:NAVA
Middle Name:
Last Name:NIV
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:NAVA
Other - Middle Name:
Other - Last Name:NIV VOGEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:159 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4526
Mailing Address - Country:US
Mailing Address - Phone:617-864-3813
Mailing Address - Fax:617-489-4117
Practice Address - Street 1:46 PEARL ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-4041
Practice Address - Country:US
Practice Address - Phone:617-864-3813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1053881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA090248OtherVLUE OPTIONS PROVIDER NUM
MA090248OtherVLUE OPTIONS PROVIDER NUM