Provider Demographics
NPI:1518121110
Name:PARADIGM COUNSELING NC
Entity Type:Organization
Organization Name:PARADIGM COUNSELING NC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LEAHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-671-2290
Mailing Address - Street 1:7038 LANDINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:27592-8620
Mailing Address - Country:US
Mailing Address - Phone:330-671-2290
Mailing Address - Fax:919-552-9918
Practice Address - Street 1:374 RALEIGH ST
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-9047
Practice Address - Country:US
Practice Address - Phone:919-601-9222
Practice Address - Fax:919-552-9918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-12
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YP2500X, 104100000X
NC5364101YM0800X
NCC0067641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH11864332OtherCAQH