Basic Information
| Provider Information | |||||||||
| NPI: | 1720734437 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PAULSEN | ||||||||
| FirstName: | DANYEL | ||||||||
| MiddleName: | ELAINE | ||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2305 PLAZA DEL PRADO | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891023976 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2132157670 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4029 DEAN MARTIN DR | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891034138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028482256 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2022 | ||||||||
| LastUpdateDate: | 02/22/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 8963-S | NV | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.