Provider Demographics
NPI:1376259382
Name:PATH TO DISCOVERY LLC
Entity Type:Organization
Organization Name:PATH TO DISCOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:R
Authorized Official - Last Name:MARX
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-CP
Authorized Official - Phone:903-760-2932
Mailing Address - Street 1:322 BLOOMSBURY CIR
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020-7958
Mailing Address - Country:US
Mailing Address - Phone:803-760-2932
Mailing Address - Fax:
Practice Address - Street 1:1220 PICKENS ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3428
Practice Address - Country:US
Practice Address - Phone:803-760-2932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health