Provider Demographics
NPI:1881123685
Name:MILFORD, PAUL CHARLES (LCSW)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:CHARLES
Last Name:MILFORD
Suffix:
Gender:M
Credentials:LCSW
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Mailing Address - Street 1:390 PONDELLA RD
Mailing Address - Street 2:STE 9
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-4340
Mailing Address - Country:US
Mailing Address - Phone:239-652-0260
Mailing Address - Fax:
Practice Address - Street 1:1242 SW PINE ISLAND RD STE 42-302
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-2120
Practice Address - Country:US
Practice Address - Phone:239-910-0712
Practice Address - Fax:317-774-5004
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLSW13480101YP2500X, 103K00000X, 1041C0700X, 101YM0800X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW13480OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH