MEDICARE: MS. LISA E 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
1	101YP2500X	Professional Counselor	63300	TX

General Provider Information

NPI Number	:	1306144787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LISA E PAGE LPC

Provider Business Mailing Address
First Line	:	2110 W SLAUGHTER LN STE 107
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78748-5978
Country	:	US
Telephone Number	:	512-545-0546
Fax Number	:	210-598-1910

Provider Business Practice Location Address
First Line	:	2500 W WILLIAM CANNON DR STE 607
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-5320
Country	:	US
Telephone Number	:	512-545-0546
Fax Number	:	210-598-1910

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2011
Last Update Date	:	02/19/2026

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