Provider Demographics
NPI:1316837941
Name:CORDER, PAIGE BROUILLETTE (LPC)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:BROUILLETTE
Last Name:CORDER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:
Other - Last Name:BROUILLETTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:8004 BROOKS RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47111-9797
Mailing Address - Country:US
Mailing Address - Phone:615-613-6937
Mailing Address - Fax:
Practice Address - Street 1:444 N NORTHWEST HWY STE 320
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-3277
Practice Address - Country:US
Practice Address - Phone:847-220-7298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.021272101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health