Provider Demographics
NPI:1689898512
Name:GALE, PAUL R (LCSW)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:R
Last Name:GALE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 HONEYSUCKLE DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-7771
Mailing Address - Country:US
Mailing Address - Phone:816-781-0044
Mailing Address - Fax:
Practice Address - Street 1:517 W WALNUT ST
Practice Address - Street 2:SUITE 2
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64050-3632
Practice Address - Country:US
Practice Address - Phone:816-461-5512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS36081041C0700X
NE9391041C0700X
MO20050358891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical