Provider Demographics
NPI:1790896272
Name:PAIGE, CAROL E (LICSW)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:E
Last Name:PAIGE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 LOG CABIN RD
Mailing Address - Street 2:
Mailing Address - City:ASHBURNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01430-1175
Mailing Address - Country:US
Mailing Address - Phone:978-827-4960
Mailing Address - Fax:
Practice Address - Street 1:27 LOG CABIN RD
Practice Address - Street 2:
Practice Address - City:ASHBURNHAM
Practice Address - State:MA
Practice Address - Zip Code:01430-1175
Practice Address - Country:US
Practice Address - Phone:978-827-4960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1024028101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health