Provider Demographics
NPI:1184760100
Name:PAVAO, JOYCE MAGUIRE (LCSW, LMFT)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:MAGUIRE
Last Name:PAVAO
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141-1204
Mailing Address - Country:US
Mailing Address - Phone:617-547-0909
Mailing Address - Fax:617-497-5952
Practice Address - Street 1:350 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02141-1204
Practice Address - Country:US
Practice Address - Phone:617-547-0909
Practice Address - Fax:617-497-5952
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2005421041C0700X
MA206106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA20052OtherTUFTS
MA04326568101OtherPACIFICARE