Provider Demographics
NPI:1104230234
Name:PAGE, UNIQUE LAYSHAUN (LPC)
Entity type:Individual
Prefix:DR
First Name:UNIQUE
Middle Name:LAYSHAUN
Last Name:PAGE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-3519
Mailing Address - Country:US
Mailing Address - Phone:562-400-8935
Mailing Address - Fax:
Practice Address - Street 1:113 N ELM ST
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013-3519
Practice Address - Country:US
Practice Address - Phone:503-372-5147
Practice Address - Fax:503-650-4302
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-17
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60476549101YM0800X
ORC4395101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health