Provider Demographics
NPI:1528514999
Name:AUSTIN, PAIGE (LCPC)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:849 FAIRMOUNT AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-2624
Mailing Address - Country:US
Mailing Address - Phone:443-377-5273
Mailing Address - Fax:443-659-2429
Practice Address - Street 1:210 ABRECHT PL
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4918
Practice Address - Country:US
Practice Address - Phone:301-663-8263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC7866101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD880603Medicaid