Provider Demographics
NPI:1386941409
Name:PATHWAYS COUNSELING CENTER
Entity type:Organization
Organization Name:PATHWAYS COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ELYSE
Authorized Official - Last Name:ZARE
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-CP
Authorized Official - Phone:864-561-1133
Mailing Address - Street 1:23 TRAILSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-3322
Mailing Address - Country:US
Mailing Address - Phone:864-561-1133
Mailing Address - Fax:864-288-0501
Practice Address - Street 1:104 RENAISSANCE CIR
Practice Address - Street 2:
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662-2455
Practice Address - Country:US
Practice Address - Phone:864-561-1133
Practice Address - Fax:864-288-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5221101YP2500X
SC84031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty