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NPI Code Detail

MEDICARE: MS. SHICAGO PAGE LPC

MEDICARE:  MS. SHICAGO  PAGE  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor3098AL
2101YM0800XMental Health Counselor72573TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285972059
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHICAGO PAGE LPC
Provider Business Mailing Address
First Line : PO BOX 182434
Second Line :
City : ARLINGTON
State : TX
Zip : 76096-2434
Country : US
Telephone Number : 205-310-8225
Fax Number :
Provider Business Practice Location Address
First Line : 539 W COMMERCE ST # 1057
Second Line :
City : DALLAS
State : TX
Zip : 75208-1953
Country : US
Telephone Number : 469-951-3697
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2013
Last Update Date : 10/05/2020

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Directions to “ MS. SHICAGO PAGE LPC” Practice Location

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