Provider Demographics
NPI:1902631849
Name:GUIDING PATHWAYS THERAPEUTIC CONSULTATION LLC
Entity type:Organization
Organization Name:GUIDING PATHWAYS THERAPEUTIC CONSULTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:LBA
Authorized Official - Phone:703-899-0274
Mailing Address - Street 1:8140 BLUEBONNET DR
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-5628
Mailing Address - Country:US
Mailing Address - Phone:703-899-0274
Mailing Address - Fax:
Practice Address - Street 1:8140 BLUEBONNET DR
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-5628
Practice Address - Country:US
Practice Address - Phone:703-899-0274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1508361718Medicaid