Provider Demographics
NPI:1629835343
Name:CARSON, PAIGE JENNA (LMHC)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:JENNA
Last Name:CARSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 DEER CT DR BLDG 17
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-6859
Mailing Address - Country:US
Mailing Address - Phone:845-987-4228
Mailing Address - Fax:
Practice Address - Street 1:15 S BRIDGE ST APT 311
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-3577
Practice Address - Country:US
Practice Address - Phone:845-987-4228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013937101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health