Healthcare Provider Details

I. General information

NPI: 1912785676
Provider Name (Legal Business Name): DEBORAH PAGANO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2023
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 WOODLAND RD STE 2
MADISON CT
06443-2380
US

IV. Provider business mailing address

19 SUNSET FARM RD
KILLINGWORTH CT
06419-1190
US

V. Phone/Fax

Practice location:
  • Phone: 203-208-8996
  • Fax:
Mailing address:
  • Phone: 203-430-0242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9283
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: