Provider Demographics
NPI:1316657653
Name:PATHWAYS PSYCHOLOGY, LLC
Entity type:Organization
Organization Name:PATHWAYS PSYCHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRISTIN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SAFFO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:336-524-1628
Mailing Address - Street 1:4400 AMBASSADOR CAFFERY PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6760
Mailing Address - Country:US
Mailing Address - Phone:336-524-1628
Mailing Address - Fax:336-792-5896
Practice Address - Street 1:100 HABERSHAM DR
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592-5116
Practice Address - Country:US
Practice Address - Phone:336-524-1628
Practice Address - Fax:336-792-5896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty