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NPI Code Detail

MEDICARE: LINDSAY PAIGE WILSON LCPC

MEDICARE:   LINDSAY PAIGE WILSON  LCPC
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
1101Y00000XCounselor180.008614IL

General Provider Information

NPI Number : 1942865696
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSAY PAIGE WILSON LCPC
Provider Business Mailing Address
First Line : 20360 STATE HIGHWAY 16
Second Line :
City : ASHMORE
State : IL
Zip : 61912-9141
Country : US
Telephone Number : 217-549-1690
Fax Number :
Provider Business Practice Location Address
First Line : 304 8TH ST
Second Line :
City : CHARLESTON
State : IL
Zip : 61920-1504
Country : US
Telephone Number : 217-345-4642
Fax Number : 217-210-0227
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2019
Last Update Date : 05/08/2019

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Directions to “ LINDSAY PAIGE WILSON LCPC” Practice Location

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