Provider Demographics
NPI:1811766686
Name:PAULUS, JIM
Entity type:Individual
Prefix:
First Name:JIM
Middle Name:
Last Name:PAULUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 WEST GRAND
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:KS
Mailing Address - Zip Code:67063
Mailing Address - Country:US
Mailing Address - Phone:620-877-7179
Mailing Address - Fax:
Practice Address - Street 1:315 S LINCOLN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:KS
Practice Address - Zip Code:67063-1714
Practice Address - Country:US
Practice Address - Phone:620-869-9986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health