NPIMap

Organization Active NPI

Paragon Behavioral Health, LLC

  • Clinical Social Worker
  • Kensington, CT
National Provider Identifier
1083731079
Registry record updated Oct 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PARAGON BEHAVIORAL HEALTH, LLC
Practice address
26 Chamberlain Hwy
Kensington, CT 06037-1921
Phone
(860) 893-0040
Fax
(860) 893-0046
NPI assigned
Mar 23, 2007
Last updated
Oct 11, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
PARAGON BEHAVIORAL HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 11, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Randi Schnur, PHDNPI 1861501827
Title
Owner
Phone
(860) 893-0040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

26 Chamberlain Hwy
Kensington, CT 06037-1921

Mailing address

26 Chamberlain Hwy
Kensington, CT 06037-1921
Phone (860) 893-0040

Other identifiers 1

IdentifierTypeStateIssuer
004254033MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060426000398 CT Part B Supplier - Clinic/Group Practice 1850301508 Receives reassigned benefits from 10 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kensington, CT

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Paragon Behavioral Health L7 organizations share this tax ID, including this one
Part of
Paragon Behavioral Health L

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286755200000",
    "number": "1083731079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 CHAMBERLAIN HWY",
            "city": "KENSINGTON",
            "state": "CT",
            "postal_code": "060371921",
            "telephone_number": "860-893-0040",
            "fax_number": "860-893-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 CHAMBERLAIN HWY",
            "city": "KENSINGTON",
            "state": "CT",
            "postal_code": "060371921",
            "telephone_number": "860-893-0040",
            "fax_number": "860-893-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARAGON BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARAGON BEHAVIORAL HEALTH",
        "enumeration_date": "2007-03-23",
        "last_updated": "2010-10-11",
        "status": "A",
        "authorized_official_last_name": "SCHNUR",
        "authorized_official_first_name": "RANDI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-893-0040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004254033",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kensington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.