Provider Demographics
NPI:1548362817
Name:MASSED, PAULINE (LICSW)
Entity type:Individual
Prefix:
First Name:PAULINE
Middle Name:
Last Name:MASSED
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 BRIGHAM STREET
Mailing Address - Street 2:STE 5
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740
Mailing Address - Country:US
Mailing Address - Phone:508-993-8332
Mailing Address - Fax:508-993-1024
Practice Address - Street 1:52 BRIGHAM STREET STE 5
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740
Practice Address - Country:US
Practice Address - Phone:508-993-8332
Practice Address - Fax:508-993-1024
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10169691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1857991Medicaid
207904OtherCIGNA
21363 1OtherBLUE CHIP OF RI
340479OtherMANAGED HEALTH NETWORK
5736031OtherAETNA CHICKERING CLAIMS
000000022710OtherBMC HEALTHNET
085884OtherHARVARD PILGRIM VALUE OPT
5736031OtherAETNA US HEALTHCARE
1892720OtherMBHP PARTNERSHIP
779224OtherSECURE HORIZONS
779224OtherTUFTS
MA 67284 HHOtherHUMANA CHOICE CARE ELECT
1030340OtherBEACON HEALTH STRATEGIES
P07602OtherBCBS OF MA
MA1857991Medicaid