Provider Demographics
NPI:1679186142
Name:PAGLINO, JILL ALEXANDRA (LCPA)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:ALEXANDRA
Last Name:PAGLINO
Suffix:
Gender:F
Credentials:LCPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:CT
Mailing Address - Zip Code:06413-2035
Mailing Address - Country:US
Mailing Address - Phone:860-664-1155
Mailing Address - Fax:860-664-4384
Practice Address - Street 1:48 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:CT
Practice Address - Zip Code:06413-2035
Practice Address - Country:US
Practice Address - Phone:860-669-1103
Practice Address - Fax:860-664-4384
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4056101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional