Provider Demographics
NPI:1619268653
Name:PARADIGM THERAPY PARTNERS LLC
Entity type:Organization
Organization Name:PARADIGM THERAPY PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:MINES
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MSA, OTR/L
Authorized Official - Phone:240-264-1621
Mailing Address - Street 1:6368 COVENTRY WAY
Mailing Address - Street 2:363
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2256
Mailing Address - Country:US
Mailing Address - Phone:240-264-1621
Mailing Address - Fax:888-242-8040
Practice Address - Street 1:4483 FORBES BLVD STE A
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4377
Practice Address - Country:US
Practice Address - Phone:240-479-6769
Practice Address - Fax:888-242-8040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT010000263225X00000X
MD05814225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1619268653OtherNPPES