Provider Demographics
NPI:1477963510
Name:BOUTTE, PAULA (LCSW)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:BOUTTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7727 LANKERSHIM BLVD
Mailing Address - Street 2:APT 115
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-6518
Mailing Address - Country:US
Mailing Address - Phone:818-205-7370
Mailing Address - Fax:
Practice Address - Street 1:7727 LANKERSHIM BLVD
Practice Address - Street 2:APT 115
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-6518
Practice Address - Country:US
Practice Address - Phone:818-205-7370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-29
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical