Provider Demographics
NPI:1194612747
Name:MOCK, PAIGE DENISE
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:DENISE
Last Name:MOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 PRESTON TRAILS DR
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-2111
Mailing Address - Country:US
Mailing Address - Phone:614-290-9586
Mailing Address - Fax:
Practice Address - Street 1:2741 S HAMILTON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-4904
Practice Address - Country:US
Practice Address - Phone:614-547-4493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator