Provider Demographics
NPI:1033340633
Name:PAGE, MARLENE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:
Last Name:PAGE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 NORTH BROADWAY
Mailing Address - Street 2:WJCS
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-2427
Mailing Address - Country:US
Mailing Address - Phone:914-761-0600
Mailing Address - Fax:914-761-5367
Practice Address - Street 1:333 PELHAM ROAD
Practice Address - Street 2:MILESTONES
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10805
Practice Address - Country:US
Practice Address - Phone:914-922-9333
Practice Address - Fax:914-922-9336
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033553-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker