Provider Demographics
NPI:1356902910
Name:BEMIS, PAULA A (LCSW)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:A
Last Name:BEMIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 THELMA DR # 421
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-2325
Mailing Address - Country:US
Mailing Address - Phone:907-727-7949
Mailing Address - Fax:
Practice Address - Street 1:330 S CENTER ST STE 404
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2876
Practice Address - Country:US
Practice Address - Phone:907-727-7949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1294831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical