Provider Demographics
NPI:1497862270
Name:HAMVAS, PAULA SUE (MA,LCSW, CEAP)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:SUE
Last Name:HAMVAS
Suffix:
Gender:F
Credentials:MA,LCSW, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9735 LANDMARK PARKWAY DR
Mailing Address - Street 2:STE 17
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-1646
Mailing Address - Country:US
Mailing Address - Phone:314-842-6223
Mailing Address - Fax:314-842-6124
Practice Address - Street 1:9735 LANDMARK PARKWAY DR
Practice Address - Street 2:STE 17
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1646
Practice Address - Country:US
Practice Address - Phone:314-842-6223
Practice Address - Fax:314-842-6124
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW001174101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
029744OtherC EAP
MOSW001174OtherLCSW