Provider Demographics
NPI:1760547020
Name:PAGE, WILLIAM WALKER (LMFT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:WALKER
Last Name:PAGE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-2329
Mailing Address - Country:US
Mailing Address - Phone:515-288-1981
Mailing Address - Fax:515-288-9109
Practice Address - Street 1:1728 CENTRAL AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-4200
Practice Address - Country:US
Practice Address - Phone:515-573-2193
Practice Address - Fax:515-288-9109
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00215106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist