MEDICARE: MS. PAULA WOODS BOONE LPC, LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	157	OK
2	101YP2500X	Professional Counselor	863	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	271008	OTHER	OK	ANHEUSER-BUSCH EAP

General Provider Information

NPI Number	:	1326015314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PAULA WOODS BOONE LPC, LMFT

Provider Business Mailing Address
First Line	:	3240 W BRITTON RD STE 102
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-2040
Country	:	US
Telephone Number	:	405-286-0077
Fax Number	:	405-418-0177

Provider Business Practice Location Address
First Line	:	3240 W BRITTON RD STE 102
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-2040
Country	:	US
Telephone Number	:	405-860-0772
Fax Number	:	405-418-0177

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	11/19/2018

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