Provider Demographics
NPI:1588312359
Name:PREFERRED PATH LLC
Entity type:Organization
Organization Name:PREFERRED PATH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/ LLC OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:RIAT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:636-486-6618
Mailing Address - Street 1:1619 SUMMER RUN DR UNIT 23
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-6440
Mailing Address - Country:US
Mailing Address - Phone:636-486-6618
Mailing Address - Fax:
Practice Address - Street 1:1619 SUMMER RUN DR UNIT 23
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-6440
Practice Address - Country:US
Practice Address - Phone:314-313-8351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-11
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO499344109Medicaid