Provider Demographics
NPI:1144429291
Name:NEW PATHWAYS THERAPEUTIC SERVICES, INC.
Entity Type:Organization
Organization Name:NEW PATHWAYS THERAPEUTIC SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWC, LICSW
Authorized Official - Phone:301-577-7390
Mailing Address - Street 1:5120 GLENN DALE WOODS CT
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-9114
Mailing Address - Country:US
Mailing Address - Phone:301-577-7390
Mailing Address - Fax:301-577-7392
Practice Address - Street 1:4200 FORBES BLVD STE 202
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4829
Practice Address - Country:US
Practice Address - Phone:301-577-7390
Practice Address - Fax:301-577-7392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD407988400Medicaid