Provider Demographics
NPI:1760043129
Name:FLORA, PAIGE JORDAN (LPCC)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:JORDAN
Last Name:FLORA
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 CHESTNUT ST STE 202
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-6922
Mailing Address - Country:US
Mailing Address - Phone:270-202-1096
Mailing Address - Fax:
Practice Address - Street 1:728 CHESTNUT ST STE 202
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-6922
Practice Address - Country:US
Practice Address - Phone:270-202-1096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY275005101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional