Healthcare Provider Details

I. General information

NPI: 1922139963
Provider Name (Legal Business Name): PAULA G. SHEARER LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 05/19/2022
Certification Date: 05/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 MESSIMER DR
NEWARK OH
43055-1874
US

IV. Provider business mailing address

65 MESSIMER DR
NEWARK OH
43055-1874
US

V. Phone/Fax

Practice location:
  • Phone: 740-788-3400
  • Fax: 740-788-3401
Mailing address:
  • Phone: 740-788-3400
  • Fax: 740-788-3401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS-0000849
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberS-0000849
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: