Provider Demographics
NPI:1750322475
Name:FROST, PAULA (LADC)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:
Last Name:FROST
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 S LUBEC RD
Mailing Address - Street 2:
Mailing Address - City:LUBEC
Mailing Address - State:ME
Mailing Address - Zip Code:04652-3620
Mailing Address - Country:US
Mailing Address - Phone:207-733-5541
Mailing Address - Fax:207-733-4767
Practice Address - Street 1:43 S LUBEC RD
Practice Address - Street 2:
Practice Address - City:LUBEC
Practice Address - State:ME
Practice Address - Zip Code:04652-3620
Practice Address - Country:US
Practice Address - Phone:207-733-5541
Practice Address - Fax:207-733-4767
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC414101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEOTH000Medicare UPIN
ME201826Medicare Oscar/Certification