Provider Demographics
NPI:1114086162
Name:WANT, PAULINA SATZ (LCSW, MS)
Entity Type:Individual
Prefix:MS
First Name:PAULINA
Middle Name:SATZ
Last Name:WANT
Suffix:
Gender:F
Credentials:LCSW, MS
Other - Prefix:MS
Other - First Name:PAULA
Other - Middle Name:SATZ
Other - Last Name:WANT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW, MS
Mailing Address - Street 1:15 PAERDEGAT 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4133
Mailing Address - Country:US
Mailing Address - Phone:718-241-1634
Mailing Address - Fax:
Practice Address - Street 1:10470 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3694
Practice Address - Country:US
Practice Address - Phone:718-275-6010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054075-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical