Provider Demographics
NPI:1215416474
Name:PAGELSON, STEPHANIE E (LMHC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:E
Last Name:PAGELSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 W 58TH ST APT 3W
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1162
Mailing Address - Country:US
Mailing Address - Phone:203-313-5181
Mailing Address - Fax:
Practice Address - Street 1:26 COURT ST STE 1302
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11242-1113
Practice Address - Country:US
Practice Address - Phone:203-313-5181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2021-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP12101101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health