Provider Demographics
NPI:1811307747
Name:STAHL, PAULA ANN (MSW, LCSW, CCTP)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:ANN
Last Name:STAHL
Suffix:
Gender:F
Credentials:MSW, LCSW, CCTP
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:ANN
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LSW
Mailing Address - Street 1:1993 CATO AVE
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-2754
Mailing Address - Country:US
Mailing Address - Phone:814-231-8820
Mailing Address - Fax:
Practice Address - Street 1:1993 CATO AVE
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-2754
Practice Address - Country:US
Practice Address - Phone:814-231-8820
Practice Address - Fax:814-231-8857
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW019719101Y00000X
PASW130910104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor