MEDICARE: JILLIAN CALLIE PAIGE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	MSW011685	GA

General Provider Information

NPI Number	:	1487518015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILLIAN CALLIE PAIGE

Provider Business Mailing Address
First Line	:	3565 PIEDMONT RD NE STE 510
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-8202
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3565 PIEDMONT RD NE STE 510
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-8202
Country	:	US
Telephone Number	:	912-667-2185
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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