Provider Demographics
NPI:1528886694
Name:PAGAN ANDINO, BRIANDA (LCSW)
Entity type:Individual
Prefix:
First Name:BRIANDA
Middle Name:
Last Name:PAGAN ANDINO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BRIANDA
Other - Middle Name:
Other - Last Name:TORRES CONLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2708 N 4TH ST STE A-6
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-1829
Mailing Address - Country:US
Mailing Address - Phone:928-250-6753
Mailing Address - Fax:
Practice Address - Street 1:2708 N 4TH ST STE A-6
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-1829
Practice Address - Country:US
Practice Address - Phone:928-250-6753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-28
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-225461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical