Provider Demographics
NPI:1114646437
Name:PARADIGM COUNSELING ASSOCIATES LLC
Entity Type:Organization
Organization Name:PARADIGM COUNSELING ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALER
Authorized Official - Prefix:
Authorized Official - First Name:JERJUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLES
Authorized Official - Suffix:
Authorized Official - Credentials:BSHSM, MSHA
Authorized Official - Phone:754-270-6322
Mailing Address - Street 1:861 NW 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-1129
Mailing Address - Country:US
Mailing Address - Phone:954-559-6093
Mailing Address - Fax:239-330-7028
Practice Address - Street 1:861 NW 72ND AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-1129
Practice Address - Country:US
Practice Address - Phone:954-559-6093
Practice Address - Fax:239-330-7028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty