Provider Demographics
NPI:1417079864
Name:PATHWAYS BEHAVIORAL SERVICES INC
Entity Type:Organization
Organization Name:PATHWAYS BEHAVIORAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:319-235-6571
Mailing Address - Street 1:3362 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-2006
Mailing Address - Country:US
Mailing Address - Phone:319-235-6571
Mailing Address - Fax:319-235-6028
Practice Address - Street 1:500 E 4TH ST
Practice Address - Street 2:ROOM 417
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-5798
Practice Address - Country:US
Practice Address - Phone:319-232-5363
Practice Address - Fax:319-232-5487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0117394Medicaid