Provider Demographics
NPI:1962926857
Name:UNIQUE PAGE COUNSELING
Entity type:Organization
Organization Name:UNIQUE PAGE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:UNIQUE
Authorized Official - Middle Name:LAYSHAUN
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:562-400-8935
Mailing Address - Street 1:11950 SW LINCOLN AVE APT 14
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-6359
Mailing Address - Country:US
Mailing Address - Phone:562-400-8935
Mailing Address - Fax:
Practice Address - Street 1:12511 SW 68TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-8298
Practice Address - Country:US
Practice Address - Phone:562-400-8935
Practice Address - Fax:562-400-8935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC4395106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty