Provider Demographics
NPI:1407264427
Name:PATHWAYS COUNSELING CENTER
Entity Type:Organization
Organization Name:PATHWAYS COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MFT
Authorized Official - Phone:951-369-7288
Mailing Address - Street 1:6840 INDIANA AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-4298
Mailing Address - Country:US
Mailing Address - Phone:951-369-7288
Mailing Address - Fax:951-369-1064
Practice Address - Street 1:6840 INDIANA AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4298
Practice Address - Country:US
Practice Address - Phone:951-369-7288
Practice Address - Fax:951-369-1064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty