Provider Demographics
NPI:1831314285
Name:PAGANO, PATRICIA L (LCSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:L
Last Name:PAGANO
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 1:46 MIANUS VIEW TER
Mailing Address - Street 2:
Mailing Address - City:COS COB
Mailing Address - State:CT
Mailing Address - Zip Code:06807-2218
Mailing Address - Country:US
Mailing Address - Phone:917-748-6457
Mailing Address - Fax:203-340-2623
Practice Address - Street 1:46 MIANUS VIEW TER
Practice Address - Street 2:
Practice Address - City:COS COB
Practice Address - State:CT
Practice Address - Zip Code:06807-2218
Practice Address - Country:US
Practice Address - Phone:917-748-6457
Practice Address - Fax:203-340-2623
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0060031041C0700X
NYPR061950-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical