Provider Demographics
NPI:1952942617
Name:CHASTAIN, PAIGE ANNE (LCSW)
Entity type:Individual
Prefix:MS
First Name:PAIGE
Middle Name:ANNE
Last Name:CHASTAIN
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7818 TAY RIVER COURT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89166
Mailing Address - Country:US
Mailing Address - Phone:802-829-3505
Mailing Address - Fax:
Practice Address - Street 1:1830 E SAHARA AVE FL 2
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3737
Practice Address - Country:US
Practice Address - Phone:702-608-9491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-03
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV06674-C101YA0400X
NVIC-2620104100000X
CACICA03380520101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker