Provider Demographics
NPI:1649917030
Name:WING, PAIGE ELIZABETH (MED LPC)
Entity type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:ELIZABETH
Last Name:WING
Suffix:
Gender:F
Credentials:MED LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 WINDSOR CIR
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:TX
Mailing Address - Zip Code:77657-7167
Mailing Address - Country:US
Mailing Address - Phone:409-658-1237
Mailing Address - Fax:
Practice Address - Street 1:350 PINE ST STE 760
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-2421
Practice Address - Country:US
Practice Address - Phone:409-223-1433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-17
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82955101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty