MEDICARE: MARILYN PAGETT LCSW

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	1041C0700X	Clinical Social Worker	C004186	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	136F1	OTHER	NC	BCBSNC GRP # 015HF
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982642575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARILYN PAGETT LCSW

Provider Business Mailing Address
First Line	:	247 BLUEBERRY LN
Second Line	:
City	:	SWANNANOA
State	:	NC
Zip	:	28778-2247
Country	:	US
Telephone Number	:	828-686-5468
Fax Number	:	828-225-4822

Provider Business Practice Location Address
First Line	:	1340 PATTON AVE STE H
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28806-2623
Country	:	US
Telephone Number	:	828-225-4980
Fax Number	:	828-225-4822

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

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	07/09/2007

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