Provider Demographics
NPI:1033680350
Name:PATHWAYS COUNSELING SERVICE, LLC
Entity Type:Organization
Organization Name:PATHWAYS COUNSELING SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:S
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC, NCC, CTT
Authorized Official - Phone:662-561-5765
Mailing Address - Street 1:105 WESTMINSTER DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-6006
Mailing Address - Country:US
Mailing Address - Phone:662-561-5765
Mailing Address - Fax:
Practice Address - Street 1:105 WESTMINSTER DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-6006
Practice Address - Country:US
Practice Address - Phone:662-561-5765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-14
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty