Provider Demographics
NPI:1982168191
Name:LAVOIE, JOSEPH (RN, APRN)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:LAVOIE
Suffix:
Gender:M
Credentials:RN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 SOMERVILLE AVE # 337
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-3347
Mailing Address - Country:US
Mailing Address - Phone:617-858-8276
Mailing Address - Fax:617-440-2464
Practice Address - Street 1:519 SOMERVILLE AVE #337
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-3238
Practice Address - Country:US
Practice Address - Phone:617-858-8276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2287662163WP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health