Provider Demographics
NPI:1811287428
Name:PATHWAYS THERAPY CENTER
Entity type:Organization
Organization Name:PATHWAYS THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATIONAL CERTIFIED COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:LAFAYETTE
Authorized Official - Last Name:FARRAR
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC, CADCII
Authorized Official - Phone:662-321-2329
Mailing Address - Street 1:302 S SPRING ST
Mailing Address - Street 2:A/B
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-4853
Mailing Address - Country:US
Mailing Address - Phone:662-840-2005
Mailing Address - Fax:662-840-2107
Practice Address - Street 1:302 S SPRING ST
Practice Address - Street 2:A/B
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-4853
Practice Address - Country:US
Practice Address - Phone:662-840-2005
Practice Address - Fax:662-840-2107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-15
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1188103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty