Provider Demographics
NPI:1992458236
Name:PAQUETTE, ABIGAIL (LISW)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:PAQUETTE
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12523 WOODSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44108-2422
Mailing Address - Country:US
Mailing Address - Phone:216-367-9392
Mailing Address - Fax:
Practice Address - Street 1:12523 WOODSIDE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108-2422
Practice Address - Country:US
Practice Address - Phone:216-367-9392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-27
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2507014104100000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2615030Medicaid
OHI.2507014OtherOHIO CSWMFT BOARD