Provider Demographics
NPI:1174829808
Name:PAULA L. MALOOF LCSW, INC.
Entity Type:Organization
Organization Name:PAULA L. MALOOF LCSW, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:MALOOF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-485-7441
Mailing Address - Street 1:1399 S 700 E STE 17
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-2171
Mailing Address - Country:US
Mailing Address - Phone:801-485-7441
Mailing Address - Fax:801-467-1693
Practice Address - Street 1:1399 S 700 E STE 17
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-2171
Practice Address - Country:US
Practice Address - Phone:801-485-7441
Practice Address - Fax:801-467-1693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-27
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14136235011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty