MEDICARE: PAIGE CLARK COUNSELING, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1033040555
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAIGE CLARK COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	13423 BLANCO RD
Second Line	:	PMB 8032
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-2187
Country	:	US
Telephone Number	:	210-347-5304
Fax Number	:

Provider Business Practice Location Address
First Line	:	102 SUTTLES AVE STE B
Second Line	:
City	:	SAN MARCOS
State	:	TX
Zip	:	78666-5015
Country	:	US
Telephone Number	:	210-347-5304
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST
Name	:	MS. PAIGE ELISE CLARK
Credential	:	LPC
Telephone Number	:	210-347-5304

Provider Enumeration Date	:	05/25/2026
Last Update Date	:	05/25/2026

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