Provider Demographics
NPI:1962654111
Name:FISHEL, PAIGE (LCSW)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:FISHEL
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 1:21351 GENTRY DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-8510
Mailing Address - Country:US
Mailing Address - Phone:703-644-8039
Mailing Address - Fax:
Practice Address - Street 1:21351 GENTRY DR
Practice Address - Street 2:SUITE 250
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-8510
Practice Address - Country:US
Practice Address - Phone:703-644-8039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904-0051701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical