Manny Paula, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

123675 Issued in MA

Practice address

Madigan Army Medical Center 9040 Jackson Ave
Tacoma, WA 98431-2104

Phone

(253) 966-3266

NPI assigned

Jun 21, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1568023489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 S STATE ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984053041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984312104",
            "telephone_number": "253-966-3266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "529 Main St Ste 106",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021291120",
            "country_code": "US",
            "telephone_number": "781-854-1417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75 Bickford St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021301401",
            "country_code": "US",
            "telephone_number": "781-854-1417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "90 Vandenberg Dr Bldg 1900",
            "address_purpose": "LOCATION",
            "city": "Hanscom AFB",
            "state": "MA",
            "postal_code": "017312104",
            "country_code": "US",
            "telephone_number": "781-225-4449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAULA",
        "first_name": "MANNY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-21",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "224111",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "123675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110171759",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Patrice Paty-Balsiger, AA
• Paul Andrew Sueno MD PLLC
• Paul Drumheller Physical Therapy PLLC
• Kaylie Marie Paul
• Paula L Schulze MD Inc PS
• Joel Jesus Paulino, M.D.
• Shane Corliss Paulino
• Roberta S Paulsen, M.A.
• Sammantha Hildur Paulsen, RD
• Philip Paulson

• Clinical Social Worker in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.