Provider Demographics
NPI:1811619026
Name:PAGE ONE LLC
Entity type:Organization
Organization Name:PAGE ONE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BIRD
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:316-640-4967
Mailing Address - Street 1:320 N PARKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-4145
Mailing Address - Country:US
Mailing Address - Phone:316-640-4967
Mailing Address - Fax:
Practice Address - Street 1:3500 N ROCK RD BLDG 550
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-1498
Practice Address - Country:US
Practice Address - Phone:316-640-4967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)