Provider Demographics
NPI:1871065243
Name:LINDSEY, NICOLE PAGAN (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:PAGAN
Last Name:LINDSEY
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:DIANE
Other - Last Name:PAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:499 ARWELL CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-6144
Mailing Address - Country:US
Mailing Address - Phone:972-977-1559
Mailing Address - Fax:
Practice Address - Street 1:13310-B BROOK LANE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWNQ
Practice Address - State:MD
Practice Address - Zip Code:21742
Practice Address - Country:US
Practice Address - Phone:301-733-0330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-26
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD231761041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical