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General NPI Number Information
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NPI Number | 1689378564
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Entity Type | Individual
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Provider Name | PAIGE SHIVELY PSYD, LPCC
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Gender | Female
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Dates
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Enumeration Date | 03/27/2023
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Last Update Date | 03/27/2023
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Provider Practice Location Address
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Address Line | 6641 N HIGH ST STE 205
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City | WORTHINGTON
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State | OH
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Zip | 43085-4038
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Country | US
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Telephone | 614-504-4466
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Fax |
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Provider Business Mailing Address
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Address Line | 5318 WHISPERING OAK BLVD
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City | HILLIARD
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State | OH
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Zip | 43026-8814
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Country | US
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Telephone | 614-203-9962
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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 | E.2303420
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License Number State | OH
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