Provider Demographics
NPI:1588905657
Name:PATHWAYS TO EMPOWERMENT, LLC
Entity type:Organization
Organization Name:PATHWAYS TO EMPOWERMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SW
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURNHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-995-5827
Mailing Address - Street 1:35 WOOLAM RD
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06088-9723
Mailing Address - Country:US
Mailing Address - Phone:860-995-5827
Mailing Address - Fax:
Practice Address - Street 1:99 MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:EAST WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06088-1602
Practice Address - Country:US
Practice Address - Phone:860-670-4997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATHWAYS TO EMPOWERMENT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0081881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty