Healthcare Provider Details

I. General information

NPI: 1275813198
Provider Name (Legal Business Name): PAIGE M DENMAN MSCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2011
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 ALLEGHENY CIR
GRAND ISLAND NE
68801-7472
US

IV. Provider business mailing address

1710 ALLEGHENY CIR
GRAND ISLAND NE
68801-7472
US

V. Phone/Fax

Practice location:
  • Phone: 308-391-3789
  • Fax:
Mailing address:
  • Phone: 83-913-7893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4370
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2124
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: