Provider Demographics
NPI:1386221786
Name:PATHWAYS TO WELLNESS COUNSELING
Entity Type:Organization
Organization Name:PATHWAYS TO WELLNESS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIN
Authorized Official - Middle Name:CORAN
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:276-782-2213
Mailing Address - Street 1:2268 LITTLE WALKER WAY
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354-6048
Mailing Address - Country:US
Mailing Address - Phone:276-782-2213
Mailing Address - Fax:
Practice Address - Street 1:2268 LITTLE WALKER WAY
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-6048
Practice Address - Country:US
Practice Address - Phone:276-782-2213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)