Healthcare Provider Details

I. General information

NPI: 1780493866
Provider Name (Legal Business Name): PAIGE SANDERS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2025
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 MARKET ST
GLASGOW MO
65254-1053
US

IV. Provider business mailing address

580 COUNTY ROAD 261
ARMSTRONG MO
65230-9652
US

V. Phone/Fax

Practice location:
  • Phone: 660-728-2228
  • Fax:
Mailing address:
  • Phone: 660-728-2228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2025001922
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: