Provider Demographics
NPI:1508952177
Name:LEVINRAD, PAULA (MSW)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:LEVINRAD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:372 W 12TH AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3493
Mailing Address - Country:US
Mailing Address - Phone:541-735-3665
Mailing Address - Fax:541-981-5165
Practice Address - Street 1:372 W 12TH AVE STE 1
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3493
Practice Address - Country:US
Practice Address - Phone:541-735-3665
Practice Address - Fax:541-981-5165
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
ORL41921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)