Healthcare Provider Details

I. General information

NPI: 1871163394
Provider Name (Legal Business Name): PARADIGM INTEGRATED BEHAVIORAL HEALTH AND WELLNESS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7404 EXECUTIVE PL STE 400
LANHAM MD
20706-6228
US

IV. Provider business mailing address

7404 EXECUTIVE PL STE 400
LANHAM MD
20706-6228
US

V. Phone/Fax

Practice location:
  • Phone: 443-826-9057
  • Fax:
Mailing address:
  • Phone: 443-826-9057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. DARIUS GWYNN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LCSW-C
Phone: 443-826-9057