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General NPI Number Information
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NPI Number | 1922176619
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Entity Type | Individual
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Provider Name | PAULA BRAWN RANDANT LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 119 S EMERSON ST # 203
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City | MOUNT PROSPECT
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State | IL
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Zip | 60056-3219
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Country | US
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Telephone | 847-922-7862
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Fax |
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Provider Business Mailing Address
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Address Line | 2624 TURNBULL ESTATES DR
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168-5454
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Country | US
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Telephone | 847-922-7862
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW16400
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License Number State | FL
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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 | 149001220
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License Number State | IL
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