Provider Demographics
NPI:1184898124
Name:WARING, PAULA K (LCSW-R, CASAC)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:K
Last Name:WARING
Suffix:
Gender:F
Credentials:LCSW-R, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 WAVERLY AVE
Mailing Address - Street 2:BLDG #3
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-1555
Mailing Address - Country:US
Mailing Address - Phone:631-363-2001
Mailing Address - Fax:631-363-2017
Practice Address - Street 1:450 WAVERLY AVE
Practice Address - Street 2:BLDG #3
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-1555
Practice Address - Country:US
Practice Address - Phone:631-363-2001
Practice Address - Fax:631-363-2017
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0420441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical