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NPI Code Detail

MEDICARE: KEIERA PAGE MS, LPC, NCC

MEDICARE: KEIERA PAGE MS, LPC, NCC
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
1101YM0800XMental Health Counselor3502AL

General Provider Information

NPI Number : 1659994770
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEIERA PAGE MS, LPC, NCC
Provider Business Mailing Address
First Line : 4031 SAMANTHA DR
Second Line :
City : MONTGOMERY
State : AL
Zip : 36109-1648
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6708 TAYLOR CIR
Second Line :
City : MONTGOMERY
State : AL
Zip : 36117-3411
Country : US
Telephone Number : 334-356-0369
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2020
Last Update Date : 10/19/2022

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