Provider Demographics
NPI:1831125780
Name:PAGE, F. KEITH (LMFT)
Entity Type:Individual
Prefix:
First Name:F. KEITH
Middle Name:
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:PO BOX 22523
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42304-2523
Mailing Address - Country:US
Mailing Address - Phone:270-684-7239
Mailing Address - Fax:270-684-7239
Practice Address - Street 1:227 SAINT ANN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-4197
Practice Address - Country:US
Practice Address - Phone:270-684-7239
Practice Address - Fax:270-684-7239
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0419101YM0800X
KYKY 0419106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000389207OtherANTHEM PIN