Provider Demographics
NPI:1215689542
Name:PAUL, PARADISE PAULA (LPC, CSOTP)
Entity type:Individual
Prefix:
First Name:PARADISE
Middle Name:PAULA
Last Name:PAUL
Suffix:
Gender:F
Credentials:LPC, CSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 W FELLS ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23222-4909
Mailing Address - Country:US
Mailing Address - Phone:804-304-8371
Mailing Address - Fax:
Practice Address - Street 1:2 W FELLS ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23222-4909
Practice Address - Country:US
Practice Address - Phone:804-304-8371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-18
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010965101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional