Healthcare Provider Details

I. General information

NPI: 1235842766
Provider Name (Legal Business Name): LAUREN PAIGE MAXWELL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAUREN PAIGE KING

II. Dates (important events)

Enumeration Date: 12/29/2022
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 KLOTZ RD
BOWLING GREEN OH
43402-4820
US

IV. Provider business mailing address

PO BOX 738
BOWLING GREEN OH
43402-0738
US

V. Phone/Fax

Practice location:
  • Phone: 419-352-7588
  • Fax:
Mailing address:
  • Phone: 419-352-7588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2406490
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: