Provider Demographics
NPI:1750861704
Name:GESICKI, PAIGE MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAIGE
Middle Name:MARIE
Last Name:GESICKI
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 1:9 N SALEM ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07801-4185
Mailing Address - Country:US
Mailing Address - Phone:201-841-0101
Mailing Address - Fax:
Practice Address - Street 1:9 N SALEM ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NJ
Practice Address - Zip Code:07801-4185
Practice Address - Country:US
Practice Address - Phone:201-841-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0201241041C0700X
IL140.0201241041C0700X
NJ44SC060934001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical