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General NPI Number Information
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NPI Number | 1992941116
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Entity Type | Individual
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Provider Name | PAMELA JO LUBIN MCGUIRE LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/17/2008
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Last Update Date | 02/25/2021
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Provider Practice Location Address
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Address Line | 638 PROSPECT AVE
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City | HARTFORD
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State | CT
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Zip | 06105-4203
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Country | US
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Telephone | 860-983-1679
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Fax | 860-516-1537
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Provider Business Mailing Address
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Address Line | 176 S MAIN ST
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City | WEST HARTFORD
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State | CT
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Zip | 06107-3452
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Country | US
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Telephone | 860-983-1679
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Fax | 860-516-1537
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 006917
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License Number State | CT
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