Provider Demographics
NPI:1528169034
Name:HARRY, PAULA F (LCSW)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:F
Last Name:HARRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:PAULA
Other - Middle Name:F
Other - Last Name:ANKARLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M/S
Mailing Address - Street 1:2211 OREGON ST STE A-2
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54902-7001
Mailing Address - Country:US
Mailing Address - Phone:920-410-7364
Mailing Address - Fax:920-230-2898
Practice Address - Street 1:2211 OREGON ST STE A-2
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54902-7001
Practice Address - Country:US
Practice Address - Phone:920-410-7364
Practice Address - Fax:920-230-2898
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1809-123101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39655100Medicaid