Provider Demographics
NPI:1063307148
Name:MARTIN, PAIGE DANIELLE (LPC)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:DANIELLE
Last Name:MARTIN
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 1:6009 CONVEYOR DR
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76031-0922
Mailing Address - Country:US
Mailing Address - Phone:817-897-4411
Mailing Address - Fax:
Practice Address - Street 1:405 AIRPORT FWY STE 2
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5334
Practice Address - Country:US
Practice Address - Phone:682-445-0431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90981101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor