Provider Demographics
NPI:1043478621
Name:PSYCHOLOGICAL PATHWAYS, LLC
Entity Type:Organization
Organization Name:PSYCHOLOGICAL PATHWAYS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/LICENSED CLINICAL PSYCHOLOG
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:CRANE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-577-0881
Mailing Address - Street 1:3025 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-1038
Mailing Address - Country:US
Mailing Address - Phone:847-577-0881
Mailing Address - Fax:847-342-0378
Practice Address - Street 1:3800 N WILKE RD
Practice Address - Street 2:SUITE 160
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1278
Practice Address - Country:US
Practice Address - Phone:847-577-0881
Practice Address - Fax:847-342-0378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-006159103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty