Provider Demographics
NPI:1730547977
Name:PARAGON WELLNESS, LLC
Entity type:Organization
Organization Name:PARAGON WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPC
Authorized Official - Phone:985-789-9496
Mailing Address - Street 1:101 MALLARD DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-7522
Mailing Address - Country:US
Mailing Address - Phone:985-789-9496
Mailing Address - Fax:
Practice Address - Street 1:726 E RUTLAND ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-3223
Practice Address - Country:US
Practice Address - Phone:985-789-9496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALPC 5820251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health