Provider Demographics
NPI:1871896027
Name:STAGER, MARLENE V (MS)
Entity type:Individual
Prefix:
First Name:MARLENE
Middle Name:V
Last Name:STAGER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1938 ROUTE 6
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-2311
Mailing Address - Country:US
Mailing Address - Phone:845-225-5650
Mailing Address - Fax:
Practice Address - Street 1:1938 ROUTE 6
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2311
Practice Address - Country:US
Practice Address - Phone:845-225-5650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor