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General NPI Number Information
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NPI Number | 1023594868
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Entity Type | Individual
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Provider Name | MARY ELIZABETH PAUL LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/16/2018
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 4229 LAFAYETTE CENTER DR STE 1675
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City | CHANTILLY
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State | VA
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Zip | 20151-1270
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Country | US
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Telephone | 855-326-4673
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Fax | 703-842-8130
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Provider Business Mailing Address
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Address Line | 2351 SPRINGSIDE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80951-4716
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Country | US
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Telephone | 979-807-4160
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904017884
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License Number State | VA
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