Provider Demographics
NPI:1386445070
Name:HEROIC PATH COUNSELING PLLC
Entity type:Organization
Organization Name:HEROIC PATH COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:SHONE
Authorized Official - Middle Name:L
Authorized Official - Last Name:TOPHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:623-698-2655
Mailing Address - Street 1:2928 9TH ST SE
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-3110
Mailing Address - Country:US
Mailing Address - Phone:623-698-2655
Mailing Address - Fax:
Practice Address - Street 1:2928 9TH ST SE
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-3110
Practice Address - Country:US
Practice Address - Phone:623-698-2655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty