Provider Demographics
NPI:1427440494
Name:THERAPAIGE LLC
Entity type:Organization
Organization Name:THERAPAIGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAIGE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHCA
Authorized Official - Phone:206-552-8207
Mailing Address - Street 1:10512 NE 68TH ST
Mailing Address - Street 2:BLDG C, STE 202
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7002
Mailing Address - Country:US
Mailing Address - Phone:206-552-8207
Mailing Address - Fax:425-822-3418
Practice Address - Street 1:10512 NE 68TH ST
Practice Address - Street 2:BLDG C, STE 202
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7002
Practice Address - Country:US
Practice Address - Phone:206-552-8207
Practice Address - Fax:425-822-3418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC 60334966101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty