Provider Demographics
NPI:1396141354
Name:GUIDED PATHWAYS CLINICAL SOLUTIONS, LLC
Entity type:Organization
Organization Name:GUIDED PATHWAYS CLINICAL SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KIU
Authorized Official - Middle Name:
Authorized Official - Last Name:EUBANKS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:443-200-4872
Mailing Address - Street 1:100 WEST RD
Mailing Address - Street 2:SUITE 316
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2331
Mailing Address - Country:US
Mailing Address - Phone:443-200-4872
Mailing Address - Fax:410-558-6393
Practice Address - Street 1:100 WEST RD
Practice Address - Street 2:SUITE 316
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2331
Practice Address - Country:US
Practice Address - Phone:443-200-4872
Practice Address - Fax:410-558-6393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05244251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health