Provider Demographics
NPI:1922143270
Name:PAGELS, CARRIE FANCETT (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:FANCETT
Last Name:PAGELS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CARRIE
Other - Middle Name:SUSAN
Other - Last Name:FANCETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:372 MCLAWS CIR.
Mailing Address - Street 2:STE. 2
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-5648
Mailing Address - Country:US
Mailing Address - Phone:757-564-3100
Mailing Address - Fax:757-564-3500
Practice Address - Street 1:372 MCLAWS CIR.
Practice Address - Street 2:STE. 2
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-5648
Practice Address - Country:US
Practice Address - Phone:757-564-3100
Practice Address - Fax:757-564-3500
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002664103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical