Provider Demographics
NPI: | 1073156725 |
---|---|
Name: | PATHWAYS TO WELLNESS COUNSELING SERVICES, PLLC |
Entity type: | Organization |
Organization Name: | PATHWAYS TO WELLNESS COUNSELING SERVICES, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER/PSYCHOTHERAPIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CRYSTAL |
Authorized Official - Middle Name: | LYNN |
Authorized Official - Last Name: | HRESKA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LCPC, CADC |
Authorized Official - Phone: | 847-999-3579 |
Mailing Address - Street 1: | 1004 W MINER ST |
Mailing Address - Street 2: | |
Mailing Address - City: | ARLINGTON HEIGHTS |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60005-1229 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 773-454-8480 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 415 W GOLF RD STE 59C |
Practice Address - Street 2: | |
Practice Address - City: | ARLINGTON HEIGHTS |
Practice Address - State: | IL |
Practice Address - Zip Code: | 60005-3923 |
Practice Address - Country: | US |
Practice Address - Phone: | 847-999-3579 |
Practice Address - Fax: | 224-404-1089 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-10-25 |
Last Update Date: | 2021-09-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |