=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720598626
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NATALIE PAGAN LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2017
-----------------------------------------------------
Last Update Date | 06/22/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15 SOUTH UNION ST 200
-----------------------------------------------------
City | LAWRENCE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01840
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-682-7289
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 50 BEACON HILL RD APT F
-----------------------------------------------------
City | WEST MILFORD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07480-1255
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 789-651-2719
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------