Provider Demographics
NPI:1124176797
Name:NORMA L. MEDWAY, PSY.D.PC
Entity type:Organization
Organization Name:NORMA L. MEDWAY, PSY.D.PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:MEDWAY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:508-753-0358
Mailing Address - Street 1:20 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-3911
Mailing Address - Country:US
Mailing Address - Phone:508-753-0358
Mailing Address - Fax:508-753-1785
Practice Address - Street 1:20 PARK AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-3911
Practice Address - Country:US
Practice Address - Phone:508-753-0358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7535103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty