MEDICARE: PARAGON COUNSELING, INC

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	1041C0700X	Clinical Social Worker	I9869	OH

General Provider Information

NPI Number	:	1295960714
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARAGON COUNSELING, INC

Provider Business Mailing Address
First Line	:	6009 LANDERHAVEN DR STE F
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-4192
Country	:	US
Telephone Number	:	216-280-3360
Fax Number	:	440-461-5033

Provider Business Practice Location Address
First Line	:	6009 LANDERHAVEN DR STE F
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-4192
Country	:	US
Telephone Number	:	216-280-3360
Fax Number	:	440-461-5033

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. FRANCES ANN HELUSKY
Credential	:	LISW
Telephone Number	:	216-280-3360

Provider Enumeration Date	:	05/28/2009
Last Update Date	:	05/28/2009

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