Provider Demographics
NPI:1457585309
Name:CARSON, PAULA ANDREE (LISW-S)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:ANDREE
Last Name:CARSON
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3962 BROWN PARK DR STE E
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-1162
Mailing Address - Country:US
Mailing Address - Phone:614-530-8800
Mailing Address - Fax:
Practice Address - Street 1:3962 BROWN PARK DR STE E
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1162
Practice Address - Country:US
Practice Address - Phone:614-530-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-06
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
OHI-0079321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical