Provider Demographics
NPI:1275685471
Name:PAGANO, LISA MICHELE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MICHELE
Last Name:PAGANO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1378
Mailing Address - Country:US
Mailing Address - Phone:484-883-1496
Mailing Address - Fax:860-767-7712
Practice Address - Street 1:7 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1378
Practice Address - Country:US
Practice Address - Phone:484-883-1496
Practice Address - Fax:860-767-7712
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTLCSW0052491041C0700X
PACW0193861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical