Provider Demographics
NPI:1346540309
Name:PAGAN, GERALDO (LMHC-GC-C)
Entity Type:Individual
Prefix:MR
First Name:GERALDO
Middle Name:
Last Name:PAGAN
Suffix:
Gender:M
Credentials:LMHC-GC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 WINTHROP AVE UNIT 11
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-3840
Mailing Address - Country:US
Mailing Address - Phone:978-476-9016
Mailing Address - Fax:
Practice Address - Street 1:15 UNION ST
Practice Address - Street 2:STE. 404
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1866
Practice Address - Country:US
Practice Address - Phone:978-476-9016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MA9504101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor