Healthcare Provider Details

I. General information

NPI: 1477417178
Provider Name (Legal Business Name): NATALIE PAICOPOLIS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1493 CAMBRIDGE ST
CAMBRIDGE MA
02139-1099
US

IV. Provider business mailing address

105 WASHINGTON ST APT 2A
SOMERVILLE MA
02143-4525
US

V. Phone/Fax

Practice location:
  • Phone: 617-665-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW2141678
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: