Provider Demographics
NPI:1801461595
Name:HANLEY, PAIGE (LPC)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:HANLEY
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 1:132 W ALLEGAN ST
Mailing Address - Street 2:
Mailing Address - City:OTSEGO
Mailing Address - State:MI
Mailing Address - Zip Code:49078-1144
Mailing Address - Country:US
Mailing Address - Phone:616-258-6058
Mailing Address - Fax:
Practice Address - Street 1:132 W ALLEGAN ST
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MI
Practice Address - Zip Code:49078-1144
Practice Address - Country:US
Practice Address - Phone:616-258-6058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401223804101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional