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General NPI Number Information
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NPI Number | 1942865696
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Entity Type | Individual
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Provider Name | LINDSAY PAIGE WILSON LCPC
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Gender | Female
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Dates
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Enumeration Date | 05/08/2019
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Last Update Date | 05/08/2019
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Provider Practice Location Address
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Address Line | 304 8TH ST
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City | CHARLESTON
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State | IL
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Zip | 61920-1504
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Country | US
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Telephone | 217-345-4642
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Fax | 217-210-0227
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Provider Business Mailing Address
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Address Line | 20360 STATE HIGHWAY 16
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City | ASHMORE
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State | IL
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Zip | 61912-9141
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Country | US
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Telephone | 217-549-1690
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 180.008614
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License Number State | IL
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