Provider Demographics
NPI:1619903499
Name:SEVER, PAULA (LCSW)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:SEVER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:
Other - Last Name:GARN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:237 26TH ST
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-3105
Mailing Address - Country:US
Mailing Address - Phone:801-625-3605
Mailing Address - Fax:801-625-3615
Practice Address - Street 1:237 26TH ST
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-3105
Practice Address - Country:US
Practice Address - Phone:801-625-3605
Practice Address - Fax:801-625-3615
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT501763035011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT876000308007Medicaid
Q17783Medicare UPIN