Healthcare Provider Details

I. General information

NPI: 1518121110
Provider Name (Legal Business Name): PARADIGM COUNSELING NC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2008
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

374 RALEIGH ST
HOLLY SPRINGS NC
27540-9047
US

IV. Provider business mailing address

7038 LANDINGHAM DR
WILLOW SPRING NC
27592-8620
US

V. Phone/Fax

Practice location:
  • Phone: 919-601-9222
  • Fax: 919-552-9918
Mailing address:
  • Phone: 330-671-2290
  • Fax: 919-552-9918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5364
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC006764
License Number StateNC

VIII. Authorized Official

Name: MS. RACHEL ANN LEAHY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 330-671-2290