MEDICARE: MR. PAUL R. GALE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	3608	KS
2	1041C0700X	Clinical Social Worker	939	NE
3	1041C0700X	Clinical Social Worker	2005035889	MO

General Provider Information

NPI Number	:	1689898512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PAUL R. GALE LCSW

Provider Business Mailing Address
First Line	:	1450 HONEYSUCKLE DR
Second Line	:
City	:	LIBERTY
State	:	MO
Zip	:	64068-7771
Country	:	US
Telephone Number	:	816-781-0044
Fax Number	:

Provider Business Practice Location Address
First Line	:	517 W WALNUT ST
Second Line	:	SUITE 2
City	:	INDEPENDENCE
State	:	MO
Zip	:	64050-3632
Country	:	US
Telephone Number	:	816-461-5512
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	07/08/2007

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Directions to “ MR. PAUL R. GALE LCSW” Practice Location

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