| Paradigm, Inc. | |
|
4054 S Memorial Dr Suite J&k Winterville NC 28590-5839 | |
| (252) 561-8112 | |
| (252) 561-7455 |
| Full Name | Paradigm, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 4054 S Memorial Dr, Winterville, North Carolina |
| Authorized Official Name and Position | Jason Tremain Barnett (CEO) |
| Authorized Official Contact | 2525618112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paradigm, Inc. Po Box 31091 Greenville NC 27833-1091 Ph: (252) 561-8112 | Paradigm, Inc. 4054 S Memorial Dr Suite J&k Winterville NC 28590-5839 Ph: (252) 561-8112 |
| NPI Number | 1841504263 |
|---|---|
| Provider Enumeration Date | 07/27/2010 |
| Last Update Date | 10/13/2017 |
| Medicare PECOS PAC ID | 4789708934 |
|---|---|
| Medicare Enrollment ID | O20100825000614 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841504263 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Mary Keenan Everette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518099712 PECOS PAC ID: 3375632557 Enrollment ID: I20071211000630 |
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