Provider Demographics
NPI:1598437436
Name:SANTMYER, PAIGE (MA NCC APC)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:SANTMYER
Suffix:
Gender:F
Credentials:MA NCC APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 WEXFORD OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-5545
Mailing Address - Country:US
Mailing Address - Phone:770-689-7828
Mailing Address - Fax:
Practice Address - Street 1:102 MACY DR
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-6329
Practice Address - Country:US
Practice Address - Phone:678-534-3824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC006821101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1851712640OtherNPI FOR GROUP THERAPY PRACTICE- ASSUMED NPPES ISSUED IT