Provider Demographics
NPI:1679634430
Name:EPPLEY, PAIGE BRADLEY (MA LMHC)
Entity Type:Individual
Prefix:MR
First Name:PAIGE
Middle Name:BRADLEY
Last Name:EPPLEY
Suffix:
Gender:M
Credentials:MA LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5987 SNOWY EGRET DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-3760
Mailing Address - Country:US
Mailing Address - Phone:941-224-3464
Mailing Address - Fax:941-922-6604
Practice Address - Street 1:5987 SNOWY EGRET DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-3760
Practice Address - Country:US
Practice Address - Phone:941-224-3464
Practice Address - Fax:941-922-6604
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5614101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health