Provider Demographics
NPI:1730918632
Name:WEGNER, PAIGE (MS, LPCC, LPC)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:WEGNER
Suffix:
Gender:F
Credentials:MS, LPCC, LPC
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:
Other - Last Name:WEGNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LPCC, LPC
Mailing Address - Street 1:S8025 FOX POINT TRL
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-2425
Mailing Address - Country:US
Mailing Address - Phone:715-461-0413
Mailing Address - Fax:
Practice Address - Street 1:S8025 FOX POINT TRL
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-2425
Practice Address - Country:US
Practice Address - Phone:715-461-0413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4631101YP2500X
MN4469101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional