Healthcare Provider Details

I. General information

NPI: 1083121990
Provider Name (Legal Business Name): PAIGE KAYIHAN COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2018
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24000 DIETZ DR
BONITA SPRINGS FL
34135-7001
US

IV. Provider business mailing address

24000 DIETZ DR
BONITA SPRINGS FL
34135-7001
US

V. Phone/Fax

Practice location:
  • Phone: 206-265-1561
  • Fax:
Mailing address:
  • Phone: 206-265-1561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAIGE MCEWEN KAYIHAN
Title or Position: PROPRIETOR
Credential: MSW, LICSW
Phone: 206-265-1561