Provider Demographics
NPI:1336034842
Name:SHARED PATHWAYS THERAPY CENTER
Entity type:Organization
Organization Name:SHARED PATHWAYS THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SEV
Authorized Official - Middle Name:
Authorized Official - Last Name:MANOUKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-927-5582
Mailing Address - Street 1:4695 MACARTHUR CT STE 1100
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1866
Mailing Address - Country:US
Mailing Address - Phone:818-927-5582
Mailing Address - Fax:
Practice Address - Street 1:4695 MACARTHUR CT STE 1100
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1866
Practice Address - Country:US
Practice Address - Phone:818-927-5582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty