Provider Demographics
NPI:1396757837
Name:PAQUETTE, JOSEPH (MSW)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:PAQUETTE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 FAIRMONT AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-3011
Mailing Address - Country:US
Mailing Address - Phone:508-421-4458
Mailing Address - Fax:
Practice Address - Street 1:275 BELMONT ST
Practice Address - Street 2:YOUTH AND FAMILY SERVICES
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-1675
Practice Address - Country:US
Practice Address - Phone:508-421-4458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10166731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1041C0700XMedicaid
MA1041C0700XMedicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER
MA1041C0700XMedicaid