Provider Demographics
NPI:1396209003
Name:BAUER, PAULA SMITH (MSW)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:SMITH
Last Name:BAUER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:POLLY
Other - Middle Name:SMITH
Other - Last Name:BAUER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:191 BRIDLE WAY
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-1901
Mailing Address - Country:US
Mailing Address - Phone:203-913-3262
Mailing Address - Fax:
Practice Address - Street 1:1552 ROBERTS DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-3222
Practice Address - Country:US
Practice Address - Phone:904-299-3420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-27
Last Update Date:2019-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical