Provider Demographics
NPI:1659246262
Name:AUSTIN, PAIGE (ALC)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1247 RUCKER BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-3630
Mailing Address - Country:US
Mailing Address - Phone:334-237-3838
Mailing Address - Fax:334-489-4606
Practice Address - Street 1:1247 RUCKER BLVD STE 6
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-3630
Practice Address - Country:US
Practice Address - Phone:334-237-3838
Practice Address - Fax:334-489-4606
Is Sole Proprietor?:No
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC05715101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health