Paula Margaret Childers, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5734 Issued in MN

Practice address

2419 Nicollet Ave
Minneapolis, MN 55404-3450

Phone

(612) 871-3320

Fax

(612) 871-0432

NPI assigned

Jan 19, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497808562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10540 XERXES AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554313336",
            "telephone_number": "952-886-9158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2419 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043450",
            "telephone_number": "612-871-3320",
            "fax_number": "612-871-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "PAULA",
        "middle_name": "MARGARET",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "5734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICSW",
            "identifier": "5734",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Chidothe, RN, CNP
• Kate Chies, NP
• Liza Carol Chigos, LPCC, LADC
• Child and Family Specialty Clinic P a
• Alissa Lynn Childers
• Children'S Clinic Network
• Children'S Health Care
• Children'S Health Care
• Children'S Health Care
• Children'S Health Care

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.