Provider Demographics
NPI:1114501194
Name:WOODBURN, PAULA A (LMHC)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:A
Last Name:WOODBURN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 NW 51ST ST
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-3222
Mailing Address - Country:US
Mailing Address - Phone:954-552-7550
Mailing Address - Fax:
Practice Address - Street 1:5010 NW 51ST ST
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33319-3222
Practice Address - Country:US
Practice Address - Phone:954-953-9505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19174101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health