Provider Demographics
NPI:1356468417
Name:PARAGON BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:PARAGON BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNUR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:860-893-0040
Mailing Address - Street 1:26 CHAMBERLAIN HWY
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06037-1921
Mailing Address - Country:US
Mailing Address - Phone:860-893-0040
Mailing Address - Fax:860-893-0046
Practice Address - Street 1:26 CHAMBERLAIN HWY
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:CT
Practice Address - Zip Code:06037-1921
Practice Address - Country:US
Practice Address - Phone:860-893-0040
Practice Address - Fax:860-893-0046
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARAGON BEHAVIORAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-23
Last Update Date:2010-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004215168Medicaid
CT004215168Medicaid