Provider Demographics
NPI:1972649853
Name:OLIVEIRA, PAULA ANNE (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:ANNE
Last Name:OLIVEIRA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 PLAISTOW ROAD
Mailing Address - Street 2:
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865
Mailing Address - Country:US
Mailing Address - Phone:603-382-7391
Mailing Address - Fax:603-382-0291
Practice Address - Street 1:80 ROUTE 125
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NH
Practice Address - Zip Code:03848
Practice Address - Country:US
Practice Address - Phone:603-642-6700
Practice Address - Fax:603-642-6701
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH14Y001377NH01OtherBCBS
NH30423186Medicaid