Provider Demographics
NPI:1205383460
Name:PAWLICKI, PAOLA (LMHC)
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:
Last Name:PAWLICKI
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 1:4031 NE 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-5730
Mailing Address - Country:US
Mailing Address - Phone:954-734-4216
Mailing Address - Fax:
Practice Address - Street 1:300 S PINE ISLAND RD STE 217
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2620
Practice Address - Country:US
Practice Address - Phone:954-734-4216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23153101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health