Provider Demographics
NPI:1356112700
Name:ACTIPES, PAIGE (LPC)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:ACTIPES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 SUNRISE PL
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:IL
Mailing Address - Zip Code:60172-3441
Mailing Address - Country:US
Mailing Address - Phone:630-824-8237
Mailing Address - Fax:
Practice Address - Street 1:900 SKOKIE BLVD STE 210
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4031
Practice Address - Country:US
Practice Address - Phone:847-580-3290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.021179101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional