Provider Demographics
NPI:1619992526
Name:PAEGLE, MAIJA GUNDEGA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MAIJA
Middle Name:GUNDEGA
Last Name:PAEGLE
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 1:40 GROVE ST
Mailing Address - Street 2:APT. 3B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-5375
Mailing Address - Country:US
Mailing Address - Phone:212-929-4334
Mailing Address - Fax:718-630-2950
Practice Address - Street 1:800 POLY PL # PLACE-122A4
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7104
Practice Address - Country:US
Practice Address - Phone:718-836-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO12933-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical