Provider Demographics
NPI:1063585701
Name:SHULMAN, PAULA MIRIAM (LCSW LADC)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:MIRIAM
Last Name:SHULMAN
Suffix:
Gender:F
Credentials:LCSW LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 814
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05250-0814
Mailing Address - Country:US
Mailing Address - Phone:802-375-2906
Mailing Address - Fax:802-375-2906
Practice Address - Street 1:2843 VT ROUTE 313 W
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05250-8926
Practice Address - Country:US
Practice Address - Phone:802-379-5117
Practice Address - Fax:802-375-2906
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4599101YA0400X
VT000345101YA0400X
VT089-00008951041C0700X
NYR040644-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN3006Medicaid
VT61825OtherMVP
NY136145OtherVALUE OPTIONS
NY136145OtherVALUE OPTIONS
VT58998Medicare UPIN
VTVN3006Medicare ID - Type UnspecifiedSOCIAL WORKER PRIVATAE PR