Provider Demographics
NPI:1932476819
Name:PAIGE, SHANNON (MSW, MPA, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:
Last Name:PAIGE
Suffix:
Gender:F
Credentials:MSW, MPA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 CLARKSON RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-3104
Mailing Address - Country:US
Mailing Address - Phone:804-217-2869
Mailing Address - Fax:804-271-1304
Practice Address - Street 1:1501 CLARKSON RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-3104
Practice Address - Country:US
Practice Address - Phone:804-217-2869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-21
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040114661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical