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General NPI Number Information
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NPI Number | 1104502665
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Entity Type | Organization
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Legal Business Name | PARAGON COUNSELING SERVICES
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Dates
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Enumeration Date | 06/27/2023
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 7051 HEATHCOTE VILLAGE WAY STE 130
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City | GAINESVILLE
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State | VA
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Zip | 20155-3198
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Country | US
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Telephone | 571-393-1227
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Fax |
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Provider Business Mailing Address
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Address Line | 8269 HIGHLAND ST
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City | MANASSAS
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State | VA
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Zip | 20110-3601
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Country | US
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Telephone | 571-393-1227
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | ROBERT LEWIS NUENKE
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Credential | LPC, NCC
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Telephone | 571-393-1227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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