Healthcare Provider Details

I. General information

NPI: 1780422154
Provider Name (Legal Business Name): PAULA SUE BINNER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2024
Last Update Date: 07/18/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HEADWAY CALIFORNIA BEHAVIORAL HEALTH SERVICES, P.C. 680 E. COLORADO BLVD, # 180, 2ND FL
PASADENA CA
91101-8608
US

IV. Provider business mailing address

PO BOX 8620
PASADENA CA
91109-8608
US

V. Phone/Fax

Practice location:
  • Phone: 646-941-7645
  • Fax: 929-596-7897
Mailing address:
  • Phone: 646-941-7645
  • Fax: 929-596-7897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS19717
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: