Provider Demographics
NPI:1558758367
Name:PAGLIARULO, CASEY MICHELLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CASEY
Middle Name:MICHELLE
Last Name:PAGLIARULO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:CASEY
Other - Middle Name:MICHELLE
Other - Last Name:PAGLIARULO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4061 SINGING POST LN NE
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-2690
Mailing Address - Country:US
Mailing Address - Phone:615-968-0180
Mailing Address - Fax:
Practice Address - Street 1:171 VILLAGE PKWY NE BLDG 8A
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-4061
Practice Address - Country:US
Practice Address - Phone:740-280-2626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-20
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
GACSW0068121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health