Provider Demographics
NPI:1043378227
Name:PATHFINDER VISIONS, INC.
Entity Type:Organization
Organization Name:PATHFINDER VISIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:LENNIHAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:505-681-0708
Mailing Address - Street 1:424 BRYN MAWR DR SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2206
Mailing Address - Country:US
Mailing Address - Phone:505-681-0708
Mailing Address - Fax:888-910-5156
Practice Address - Street 1:107 BRYN MAWR DR SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2206
Practice Address - Country:US
Practice Address - Phone:505-681-0708
Practice Address - Fax:888-910-5156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM93501101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM65873874Medicaid