MEDICARE: MR. MICHAEL CHRISTOPHER PAONI HSP-PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	2092	NC
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	1303	NC

General Provider Information

NPI Number	:	1285708917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL CHRISTOPHER PAONI HSP-PA

Provider Business Mailing Address
First Line	:	BLDG # -3219 2817 ROCK MERRITT AVE
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:	910-907-6825
Fax Number	:

Provider Business Practice Location Address
First Line	:	BLDG # 4-3219 2817 ROCK MERRITT AVE
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:	910-907-6825
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	10/27/2025

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