Healthcare Provider Details

I. General information

NPI: 1841779857
Provider Name (Legal Business Name): PAIGE COLETTE EARLEY NCC LPC LCADC ACS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAIGE COLETTE PALUMBO NCC LPC LCADC ACS

II. Dates (important events)

Enumeration Date: 08/09/2018
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 GLASGOW RD
WILLIAMSTOWN NJ
08094-2942
US

IV. Provider business mailing address

27 GLASGOW RD
WILLIAMSTOWN NJ
08094-2942
US

V. Phone/Fax

Practice location:
  • Phone: 856-373-0645
  • Fax:
Mailing address:
  • Phone: 856-373-0645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00639200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00279100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: