Provider Demographics
NPI:1124407572
Name:KADIANT PATHFINDER
Entity Type:Organization
Organization Name:KADIANT PATHFINDER
Other - Org Name:PATHFINDER PROGRESS, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TORI
Authorized Official - Middle Name:
Authorized Official - Last Name:BEJAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-444-2169
Mailing Address - Street 1:PO BOX 399318
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94139-9318
Mailing Address - Country:US
Mailing Address - Phone:866-523-4268
Mailing Address - Fax:
Practice Address - Street 1:3070 RIVERSIDE DR STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2547
Practice Address - Country:US
Practice Address - Phone:866-523-4268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KADIANT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-19
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-09-5335103K00000X
OH0-15-6519103K00000X, 103K00000X
OH6903103TB0200X, 103TP2701X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty