Provider Demographics
NPI:1134270796
Name:LLANEZA, PAULA GISELA (MA, LMHC)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:GISELA
Last Name:LLANEZA
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 CHESTNUT HILL RD
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-1309
Mailing Address - Country:US
Mailing Address - Phone:617-596-5004
Mailing Address - Fax:
Practice Address - Street 1:41 CHESTNUT HILL RD
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-1309
Practice Address - Country:US
Practice Address - Phone:617-596-5004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5556101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health