Provider Demographics
NPI:1780218370
Name:STANFIELD-MYERS, PAIGE (PHD LPC)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:STANFIELD-MYERS
Suffix:
Gender:F
Credentials:PHD LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 804
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-0804
Mailing Address - Country:US
Mailing Address - Phone:816-419-3146
Mailing Address - Fax:
Practice Address - Street 1:549 SE SHILOH DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-1036
Practice Address - Country:US
Practice Address - Phone:816-419-3146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000159892101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1114966041OtherINSTITUTE ON LIFE TRANSITION