Provider Demographics
NPI:1467508945
Name:PAGOTO, MARIA (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:
Last Name:PAGOTO
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 ROUTE 111
Mailing Address - Street 2:SUITE103
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-4756
Mailing Address - Country:US
Mailing Address - Phone:631-612-8733
Mailing Address - Fax:
Practice Address - Street 1:363 ROUTE 111
Practice Address - Street 2:SUITE 103
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-4756
Practice Address - Country:US
Practice Address - Phone:631-612-8733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR055646-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical