Provider Demographics
NPI:1720595986
Name:PAGAN, JACEIL (MS IN MH COUSNELING)
Entity Type:Individual
Prefix:MR
First Name:JACEIL
Middle Name:
Last Name:PAGAN
Suffix:
Gender:M
Credentials:MS IN MH COUSNELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7116 OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2261
Mailing Address - Country:US
Mailing Address - Phone:513-785-6906
Mailing Address - Fax:
Practice Address - Street 1:7116 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2261
Practice Address - Country:US
Practice Address - Phone:513-785-6906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator