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NPI Code Detail

MEDICARE: MRS. STEPHANIE GOLDBERG PASKIEVICH LICSW

MEDICARE: MRS. STEPHANIE GOLDBERG PASKIEVICH LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker213472MA
2104100000XSocial Worker116106MD

General Provider Information

NPI Number : 1073782561
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STEPHANIE GOLDBERG PASKIEVICH LICSW
Provider Business Mailing Address
First Line : 164 COURT RD
Second Line :
City : WINTHROP
State : MA
Zip : 02152-2312
Country : US
Telephone Number : 978-430-8621
Fax Number :
Provider Business Practice Location Address
First Line : 100 CUMMINGS CTR STE 307L
Second Line :
City : BEVERLY
State : MA
Zip : 01915-6107
Country : US
Telephone Number : 978-430-8621
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2008
Last Update Date : 04/20/2012

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