Healthcare Provider Details

I. General information

NPI: 1578390738
Provider Name (Legal Business Name): PAIGE RENAE NEWTON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2024
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 CARE DR
HILLSDALE MI
49242-5054
US

IV. Provider business mailing address

1200 N WEST AVE
JACKSON MI
49202-2179
US

V. Phone/Fax

Practice location:
  • Phone: 517-439-2641
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6451023320
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: