Provider Demographics
NPI:1083753362
Name:PATHWAYS SOCIAL WORK SERVICES, LLC.
Entity Type:Organization
Organization Name:PATHWAYS SOCIAL WORK SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:LOCKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-432-0381
Mailing Address - Street 1:2626 SOUTH LOOP W STE 238
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2654
Mailing Address - Country:US
Mailing Address - Phone:713-432-0381
Mailing Address - Fax:713-592-9461
Practice Address - Street 1:2626 SOUTH LOOP W STE 238
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2654
Practice Address - Country:US
Practice Address - Phone:713-432-0381
Practice Address - Fax:713-592-9461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00514251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1030223-01Medicaid
TX1030223-01Medicaid