Provider Demographics
NPI:1518471952
Name:PAIGE OVERLAND CONSULTING LLC
Entity Type:Organization
Organization Name:PAIGE OVERLAND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:OVERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:210-951-8263
Mailing Address - Street 1:PO BOX 141911
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78714-1911
Mailing Address - Country:US
Mailing Address - Phone:210-951-8263
Mailing Address - Fax:
Practice Address - Street 1:11017 LIBERTY FARMS DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-5971
Practice Address - Country:US
Practice Address - Phone:210-951-8263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-21
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies