Provider Demographics
NPI:1992481832
Name:POSITIVE PATHWAYS BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:POSITIVE PATHWAYS BEHAVIORAL HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:E
Authorized Official - Last Name:TREMPE
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:603-721-2173
Mailing Address - Street 1:12 DALE ST PO BOX 1091
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:NH
Mailing Address - Zip Code:03086
Mailing Address - Country:US
Mailing Address - Phone:603-721-2173
Mailing Address - Fax:
Practice Address - Street 1:15 MAIN ST UNIT D
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:NH
Practice Address - Zip Code:03086-4402
Practice Address - Country:US
Practice Address - Phone:603-721-2173
Practice Address - Fax:603-589-7107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3141365Medicaid