Provider Demographics
NPI:1144591074
Name:SPANGLER, PAIGE STEPHANIE (LPC)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:STEPHANIE
Last Name:SPANGLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:STEPHANIE
Other - Last Name:LEMAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:44 E MAIN ST
Mailing Address - Street 2:SUITE 406
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-3636
Mailing Address - Country:US
Mailing Address - Phone:217-398-9066
Mailing Address - Fax:217-398-9077
Practice Address - Street 1:44 E MAIN ST
Practice Address - Street 2:SUITE 406
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-3636
Practice Address - Country:US
Practice Address - Phone:217-398-9066
Practice Address - Fax:217-398-9077
Is Sole Proprietor?:No
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178007793101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional