NPI Code Details Logo

NPI 1477963510

NPI 1477963510 : PAULA BOUTTE LCSW : NORTH HOLLYWOOD, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1477963510
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    PAULA BOUTTE LCSW
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    04/29/2014
-----------------------------------------------------
    Last Update Date     |    05/18/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    11943 VANOWEN ST APT 101 
-----------------------------------------------------
    City                 |    NORTH HOLLYWOOD
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    91605-5975
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    818-205-7370
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    11943 VANOWEN ST APT 101 
-----------------------------------------------------
    City                 |    NORTH HOLLYWOOD
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    91605-5975
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    818-205-7370
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    1041C0700X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Social Worker
-----------------------------------------------------
    License Number       |    74246
-----------------------------------------------------
    License Number State |    CA
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.