Provider Demographics
NPI:1447093067
Name:NORTH, PAUL A (PLMHP)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:NORTH
Suffix:
Gender:M
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 SANDRA CT
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-4349
Mailing Address - Country:US
Mailing Address - Phone:308-635-0204
Mailing Address - Fax:
Practice Address - Street 1:3350 10TH ST
Practice Address - Street 2:
Practice Address - City:GERING
Practice Address - State:NE
Practice Address - Zip Code:69341-1724
Practice Address - Country:US
Practice Address - Phone:888-448-9665
Practice Address - Fax:308-635-0264
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13780101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health