Provider Demographics
NPI:1790581049
Name:RANDALL, PAULA (CSW)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:RANDALL
Suffix:
Gender:
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1366 S LEGEND HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84015-2371
Mailing Address - Country:US
Mailing Address - Phone:385-442-5144
Mailing Address - Fax:
Practice Address - Street 1:1366 S LEGEND HILLS DR STE 120
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:UT
Practice Address - Zip Code:84015-2372
Practice Address - Country:US
Practice Address - Phone:385-442-5144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14196750-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty