Provider Demographics
NPI: | 1285246991 |
---|---|
Name: | PATHWAYS HUMAN SERVICES OF NORTH CAROLINA, LLC |
Entity type: | Organization |
Organization Name: | PATHWAYS HUMAN SERVICES OF NORTH CAROLINA, LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CONTRACT MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MELISSA |
Authorized Official - Middle Name: | KAY |
Authorized Official - Last Name: | HEDDEN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 828-287-7945 |
Mailing Address - Street 1: | 10304 SPOTSYLVANIA AVE STE 300 |
Mailing Address - Street 2: | |
Mailing Address - City: | FREDERICKSBURG |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 22408-8605 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 540-710-6085 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 8390 SIX FORKS RD STE 201 |
Practice Address - Street 2: | |
Practice Address - City: | RALEIGH |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27615-3060 |
Practice Address - Country: | US |
Practice Address - Phone: | 828-670-7723 |
Practice Address - Fax: | 828-670-7727 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-08-24 |
Last Update Date: | 2024-07-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health | Group - Multi-Specialty | |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
No | 253J00000X | Agencies | Foster Care Agency | Group - Multi-Specialty | |
No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |
No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 103TS0200X | Behavioral Health & Social Service Providers | Psychologist | School | Group - Multi-Specialty |
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 1041S0200X | Behavioral Health & Social Service Providers | Social Worker | School | Group - Multi-Specialty |
No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty |