MEDICARE: DOREATHA L 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	101YM0800X	Mental Health Counselor	92035	TX
2	101YP2500X	Professional Counselor	92035	TX
3	101Y00000X	Counselor	92035	TX

General Provider Information

NPI Number	:	1659026763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOREATHA L PAGE LPC

Provider Business Mailing Address
First Line	:	1919 TAYLOR ST STE 1349
Second Line	:	STE 1349
City	:	HOUSTON
State	:	TX
Zip	:	77007-3973
Country	:	US
Telephone Number	:	612-389-0270
Fax Number	:

Provider Business Practice Location Address
First Line	:	5330 GRIGGS RD STE A108
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77021-3758
Country	:	US
Telephone Number	:	515-943-0878
Fax Number	:

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

Provider Enumeration Date	:	02/16/2022
Last Update Date	:	12/18/2025

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Directions to “ DOREATHA L PAGE LPC” Practice Location

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