MEDICARE: PARADIGM COUNSELING LLC

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1902638067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARADIGM COUNSELING LLC

Provider Business Mailing Address
First Line	:	5439 ROYAL ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70117-3040
Country	:	US
Telephone Number	:	504-628-0774
Fax Number	:

Provider Business Practice Location Address
First Line	:	5439 ROYAL ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70117-3040
Country	:	US
Telephone Number	:	504-628-0774
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHELIA FREY
Credential	:
Telephone Number	:	504-628-0774

Provider Enumeration Date	:	08/16/2024
Last Update Date	:	08/16/2024

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