Healthcare Provider Details
I. General information
NPI: 1023616976
Provider Name (Legal Business Name): KA PAIGE & ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/13/2020
Last Update Date: 10/13/2020
Certification Date: 10/13/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2300 GARRISON BLVD STE 150
BALTIMORE MD
21216-2316
US
IV. Provider business mailing address
2300 GARRISON BLVD STE 150
BALTIMORE MD
21216-2316
US
V. Phone/Fax
- Phone: 410-233-3111
- Fax: 410-233-3222
- Phone: 443-858-4154
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
KARL
A.
PAIGE
Title or Position: OWNER
Credential: LCPC
Phone: 443-858-4154