Provider Demographics
NPI:1881300176
Name:SWARTHOUT, PAIGE NICOLE
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:NICOLE
Last Name:SWARTHOUT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7441 114TH AVE STE 604
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-5124
Mailing Address - Country:US
Mailing Address - Phone:727-492-5369
Mailing Address - Fax:
Practice Address - Street 1:34644 GALLA RD
Practice Address - Street 2:
Practice Address - City:FRUITLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:34731-3427
Practice Address - Country:US
Practice Address - Phone:352-630-1501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-25-15863106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst