Provider Demographics
NPI:1194363804
Name:PATHWAY PSYCHIATRY AND COUNSELING CENTER, PLLC
Entity Type:Organization
Organization Name:PATHWAY PSYCHIATRY AND COUNSELING CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-997-4459
Mailing Address - Street 1:211 MASTERS AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-3638
Mailing Address - Country:US
Mailing Address - Phone:214-997-4459
Mailing Address - Fax:972-848-8592
Practice Address - Street 1:404 S JACKSON AVE SUITE 102
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098
Practice Address - Country:US
Practice Address - Phone:214-997-4459
Practice Address - Fax:972-848-8592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-12
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty