Provider Demographics
NPI:1912399544
Name:PARAMOUNT PATHWAYS
Entity Type:Organization
Organization Name:PARAMOUNT PATHWAYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL SOCIAL WORKER/EMPLOYMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:AVIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:201-213-5658
Mailing Address - Street 1:3 BELLEVIEW CT APT B
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-1494
Mailing Address - Country:US
Mailing Address - Phone:201-213-5658
Mailing Address - Fax:201-510-0784
Practice Address - Street 1:117 KINDERKAMACK RD
Practice Address - Street 2:SUITE 107
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-1941
Practice Address - Country:US
Practice Address - Phone:201-213-5658
Practice Address - Fax:201-510-0784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ9537111041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Single Specialty