Provider Demographics
NPI:1174059463
Name:DUNLAP, PAIGE NICOLE (LPC,CRC,NCC,ACS,PVE)
Entity type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:NICOLE
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:LPC,CRC,NCC,ACS,PVE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SHORTHORN CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-9765
Mailing Address - Country:US
Mailing Address - Phone:505-906-1333
Mailing Address - Fax:
Practice Address - Street 1:2307 W CONE BLVD STE 245
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-4057
Practice Address - Country:US
Practice Address - Phone:336-279-4634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-04
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12806101YP2500X
GALPC007350101YP2500X
MI6401013236101YP2500X
00102730225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor