Provider Demographics
NPI:1043550445
Name:PAIVA, MICHELE MARIA (CHT)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:MARIA
Last Name:PAIVA
Suffix:
Gender:F
Credentials:CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 RIDGEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-1351
Mailing Address - Country:US
Mailing Address - Phone:484-574-3795
Mailing Address - Fax:
Practice Address - Street 1:109 RIDGEWOOD CIR
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-1351
Practice Address - Country:US
Practice Address - Phone:484-574-3795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0000367101Y00000X
PA7358146174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor