Provider Demographics
NPI:1023593506
Name:MAUTE, PAULA J (LICSW)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:J
Last Name:MAUTE
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 1:68 BOLTON ST # 1
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-3311
Mailing Address - Country:US
Mailing Address - Phone:617-547-7647
Mailing Address - Fax:
Practice Address - Street 1:68 BOLTON ST # 1
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-3311
Practice Address - Country:US
Practice Address - Phone:617-547-7647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1135671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical