Healthcare Provider Details

I. General information

NPI: 1114791688
Provider Name (Legal Business Name): PARAGON CONCIERGE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2023
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 NAT TURNER BLVD S STE 1A
NEWPORT NEWS VA
23606-2998
US

IV. Provider business mailing address

200 NAT TURNER BLVD S STE 1A
NEWPORT NEWS VA
23606-2998
US

V. Phone/Fax

Practice location:
  • Phone: 757-266-2791
  • Fax: 833-466-1915
Mailing address:
  • Phone: 757-266-2791
  • Fax: 833-466-1915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. NICOLA HALL
Title or Position: OWNER
Credential: LPC, LMT
Phone: 757-266-2791