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NPI Code Detail

MEDICARE: ZACHARY PAULSON LCSW

MEDICARE: ZACHARY PAULSON 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
11041C0700XClinical Social Worker809AK

General Provider Information

NPI Number : 1710388608
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHARY PAULSON LCSW
Provider Business Mailing Address
First Line : 4000 SAN ERNESTO AVE
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-2874
Country : US
Telephone Number : 907-729-5030
Fax Number :
Provider Business Practice Location Address
First Line : 4000 SAN ERNESTO AVE
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-2874
Country : US
Telephone Number : 907-729-5030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2014
Last Update Date : 09/10/2014

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Directions to “ ZACHARY PAULSON LCSW” Practice Location

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