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General NPI Number Information
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NPI Number | 1235578469
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Entity Type | Individual
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Provider Name | MELINDA ROSE PAIGE ED.S, LMHC, LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 06/20/2013
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Provider Practice Location Address
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Address Line | 1640 POWERS FERRY RD SE BLDG 7, SUITE 300
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City | MARIETTA
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State | GA
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Zip | 30067-5491
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Country | US
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Telephone | 770-988-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 1516 TAPPAHANNOCK TRL
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City | MARIETTA
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State | GA
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Zip | 30062-2079
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Country | US
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Telephone | 678-848-9031
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 006576
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License Number State | GA
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