Healthcare Provider Details

I. General information

NPI: 1215539481
Provider Name (Legal Business Name): PAIGE LUCAS MSW, LSW, LCDC III
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PAIGE MARTIN

II. Dates (important events)

Enumeration Date: 11/12/2020
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 FREEDOM DR
NAPOLEON OH
43545-9038
US

IV. Provider business mailing address

245 W ELM ST
WAUSEON OH
43567-1146
US

V. Phone/Fax

Practice location:
  • Phone: 419-599-1660
  • Fax:
Mailing address:
  • Phone: 419-388-7342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCDCIII.162653
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2512780
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: