Provider Demographics
NPI:1952426728
Name:BENDER, PAIGE A (MED,LPC)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:A
Last Name:BENDER
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 1:233 ROGUE RIVER HWY
Mailing Address - Street 2:297
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-1600
Mailing Address - Country:US
Mailing Address - Phone:541-660-0080
Mailing Address - Fax:541-479-5807
Practice Address - Street 1:777 NE 7TH ST
Practice Address - Street 2:203
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1632
Practice Address - Country:US
Practice Address - Phone:541-660-0080
Practice Address - Fax:541-479-5807
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC0634101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional