Provider Demographics
NPI:1255477204
Name:COMMUNITY PATHWAYS UNLIMITED, INC.
Entity Type:Organization
Organization Name:COMMUNITY PATHWAYS UNLIMITED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAUREL
Authorized Official - Middle Name:A
Authorized Official - Last Name:VAN HORN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:405-842-4911
Mailing Address - Street 1:4045 NW 64TH ST
Mailing Address - Street 2:SUITE 520
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-1684
Mailing Address - Country:US
Mailing Address - Phone:405-842-4911
Mailing Address - Fax:405-842-5807
Practice Address - Street 1:4045 NW 64TH ST
Practice Address - Street 2:SUITE 520
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1684
Practice Address - Country:US
Practice Address - Phone:405-842-4911
Practice Address - Fax:405-842-5807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK260103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty