Provider Demographics
NPI:1083208672
Name:SACRED PATHWAYS COUNSELING
Entity Type:Organization
Organization Name:SACRED PATHWAYS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-382-6224
Mailing Address - Street 1:5 SOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14469-9218
Mailing Address - Country:US
Mailing Address - Phone:585-382-6224
Mailing Address - Fax:
Practice Address - Street 1:5 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NY
Practice Address - Zip Code:14469-9218
Practice Address - Country:US
Practice Address - Phone:585-382-6224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty