Provider Demographics
NPI:1841813003
Name:THE SHEPHERDS NEW PATHWAYS, LLC
Entity type:Organization
Organization Name:THE SHEPHERDS NEW PATHWAYS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:THIELEPAPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-228-5830
Mailing Address - Street 1:5293 S 31ST ST STE 137
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-3575
Mailing Address - Country:US
Mailing Address - Phone:254-228-5830
Mailing Address - Fax:254-598-2537
Practice Address - Street 1:3003 DAWN DR STE 101
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-2800
Practice Address - Country:US
Practice Address - Phone:254-228-5830
Practice Address - Fax:254-598-2537
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE SHEPHERD'S NEW PATHWAYS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-22
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX409273601Medicaid
TX1356779706OtherNPI