Healthcare Provider Details

I. General information

NPI: 1184733107
Provider Name (Legal Business Name): PARAGON BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 10/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 CHAMBERLAIN HWY
KENSINGTON CT
06037-1921
US

IV. Provider business mailing address

26 CHAMBERLAIN HWY
KENSINGTON CT
06037-1921
US

V. Phone/Fax

Practice location:
  • Phone: 860-893-0040
  • Fax: 860-893-0046
Mailing address:
  • Phone: 860-893-0040
  • Fax: 860-893-0046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 9
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RANDI SCHNUR
Title or Position: CLINICAL DIRECTOR
Credential: PH.D.
Phone: 860-893-0040