Healthcare Provider Details

I. General information

NPI: 1124551254
Provider Name (Legal Business Name): PAGE ELGIN MED, MS., LPC, RPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2017
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 E VICTORY DR STE E1013
SAVANNAH GA
31404-3720
US

IV. Provider business mailing address

1915 E VICTORY DR STE E1013
SAVANNAH GA
31404-3720
US

V. Phone/Fax

Practice location:
  • Phone: 713-366-2914
  • Fax:
Mailing address:
  • Phone: 713-366-2914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC011920
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number76004
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: