MEDICARE: CATHERINE A LAVOIE MSN, APRN

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	001454	CT

General Provider Information

NPI Number	:	1972501922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE A LAVOIE MSN, APRN

Provider Business Mailing Address
First Line	:	78 EAST ST
Second Line	:
City	:	BETHLEHEM
State	:	CT
Zip	:	06751-1801
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 MEADOW ST STE 1
Second Line	:
City	:	LITCHFIELD
State	:	CT
Zip	:	06759-3504
Country	:	US
Telephone Number	:	860-488-1919
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	10/30/2013

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