Provider Demographics
NPI:1992941116
Name:MCGUIRE, PAMELA JO LUBIN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:JO LUBIN
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:176 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-3452
Mailing Address - Country:US
Mailing Address - Phone:860-983-1679
Mailing Address - Fax:860-516-1537
Practice Address - Street 1:638 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-4203
Practice Address - Country:US
Practice Address - Phone:860-983-1679
Practice Address - Fax:860-516-1537
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-17
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0069171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical