Provider Demographics
NPI:1659643393
Name:WOMACK, PAULA RAE (MA, MHP, LMHCA)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:RAE
Last Name:WOMACK
Suffix:
Gender:F
Credentials:MA, MHP, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8450 24TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98106-2209
Mailing Address - Country:US
Mailing Address - Phone:206-491-1394
Mailing Address - Fax:
Practice Address - Street 1:8450 24TH AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98106-2209
Practice Address - Country:US
Practice Address - Phone:206-491-1394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-26
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60277673101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health