Provider Demographics
NPI:1437626959
Name:BOND, PAIGE NICOLE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:PAIGE
Middle Name:NICOLE
Last Name:BOND
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N RONALD REAGAN BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4162
Mailing Address - Country:US
Mailing Address - Phone:321-282-3575
Mailing Address - Fax:
Practice Address - Street 1:300 N RONALD REAGAN BLVD STE 101
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4162
Practice Address - Country:US
Practice Address - Phone:321-282-3575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-02
Last Update Date:2021-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
FLMT3864106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor