Provider Demographics
NPI:1881889376
Name:LOCKE, PAULA (LCSW, CAP)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:
Last Name:LOCKE
Suffix:
Gender:F
Credentials:LCSW, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9470 LIVE OAK PL
Mailing Address - Street 2:SUITE # D-405
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-4769
Mailing Address - Country:US
Mailing Address - Phone:954-234-2724
Mailing Address - Fax:954-302-1806
Practice Address - Street 1:9470 LIVE OAK PL
Practice Address - Street 2:SUITE # D-405
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33324-4769
Practice Address - Country:US
Practice Address - Phone:954-234-2724
Practice Address - Fax:954-302-1830
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3324101YA0400X
TN7091104100000X
FLSW 9510103K00000X, 101YP2500X, 1041C0700X
FLLCSW101YM0800X
FLCAP 3324101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional