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General NPI Number Information
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NPI Number | 1073089199
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Entity Type | Individual
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Provider Name | PAUL SCARBERRY LMHC-A, SUDP
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Gender | Male
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Dates
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Enumeration Date | 10/16/2018
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 201 160TH ST S STE 101
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City | SPANAWAY
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State | WA
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Zip | 98387-8508
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Country | US
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Telephone | 253-904-6038
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Fax | 253-409-2622
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Provider Business Mailing Address
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Address Line | PO BOX 382
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City | ELBE
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State | WA
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Zip | 98330-0382
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Country | US
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Telephone | 253-878-0536
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CP61300281
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MC61508522
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License Number State | WA
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