Provider Demographics
NPI:1275978728
Name:PAGAN-MALE, BRITTANY (LCSW, CADC, DVPC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:PAGAN-MALE
Suffix:
Gender:F
Credentials:LCSW, CADC, DVPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 276
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-0276
Mailing Address - Country:US
Mailing Address - Phone:815-758-8400
Mailing Address - Fax:815-758-8441
Practice Address - Street 1:2128 MIDLANDS CT
Practice Address - Street 2:SUITE 107
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-3199
Practice Address - Country:US
Practice Address - Phone:815-758-8400
Practice Address - Fax:815-758-8441
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490157851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical