Provider Demographics
NPI:1457410334
Name:CAVER, PAUL S (LICSW)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:S
Last Name:CAVER
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 LYME RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755-1260
Mailing Address - Country:US
Mailing Address - Phone:603-643-4005
Mailing Address - Fax:603-643-4005
Practice Address - Street 1:45 LYME RD
Practice Address - Street 2:SUITE 200
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-1219
Practice Address - Country:US
Practice Address - Phone:603-643-4005
Practice Address - Fax:603-643-4005
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR043783101YM0800X
NH15281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30428871Medicaid
NY00542498Medicaid
NH0022113Medicare Oscar/Certification
NY52928AMedicare ID - Type Unspecified