Provider Demographics
NPI:1982243838
Name:BLOCKER, PAULA JANE (LICSW)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:JANE
Last Name:BLOCKER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:JANE
Other - Last Name:SKALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LGSW, LSW
Mailing Address - Street 1:3201 1ST ST
Mailing Address - Street 2:
Mailing Address - City:EMMETSBURG
Mailing Address - State:IA
Mailing Address - Zip Code:50536-2516
Mailing Address - Country:US
Mailing Address - Phone:712-852-5500
Mailing Address - Fax:
Practice Address - Street 1:3201 1ST ST
Practice Address - Street 2:
Practice Address - City:EMMETSBURG
Practice Address - State:IA
Practice Address - Zip Code:50536-2516
Practice Address - Country:US
Practice Address - Phone:712-852-5500
Practice Address - Fax:712-852-5544
Is Sole Proprietor?:No
Enumeration Date:2019-12-24
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN25437101YM0800X
IA099668104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health