Provider Demographics
NPI:1194332015
Name:HEALING PATHWAYS COUNSELING & SUPERVISION CENTER, LLC
Entity type:Organization
Organization Name:HEALING PATHWAYS COUNSELING & SUPERVISION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, ACS
Authorized Official - Phone:908-434-6008
Mailing Address - Street 1:233 MOUNT AIRY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-2338
Mailing Address - Country:US
Mailing Address - Phone:908-434-6008
Mailing Address - Fax:
Practice Address - Street 1:233 MOUNT AIRY RD STE 100
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-2338
Practice Address - Country:US
Practice Address - Phone:908-434-6008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty