Provider Demographics
NPI:1285465278
Name:RUPP, PAIGE (LMSW)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:RUPP
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 39
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:KS
Mailing Address - Zip Code:66748-0039
Mailing Address - Country:US
Mailing Address - Phone:620-365-5717
Mailing Address - Fax:
Practice Address - Street 1:826 E MADISON AVE
Practice Address - Street 2:
Practice Address - City:IOLA
Practice Address - State:KS
Practice Address - Zip Code:66749-3555
Practice Address - Country:US
Practice Address - Phone:620-365-7890
Practice Address - Fax:620-365-8642
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13846-T104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker