Provider Demographics
NPI:1649836891
Name:HEAD, PAIGE (LPC, RPT)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:HEAD
Suffix:
Gender:F
Credentials:LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5630 HORSEBARN CT
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30028-0786
Mailing Address - Country:US
Mailing Address - Phone:404-313-9315
Mailing Address - Fax:
Practice Address - Street 1:5991 PARKWAY NORTH BLVD STE D
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-1343
Practice Address - Country:US
Practice Address - Phone:770-637-9747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-14
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health