Provider Demographics
NPI:1417421769
Name:PATHWAYS TO WELLNESS
Entity Type:Organization
Organization Name:PATHWAYS TO WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SKINNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-207-2300
Mailing Address - Street 1:PO BOX 184
Mailing Address - Street 2:
Mailing Address - City:MERRIMAN
Mailing Address - State:NE
Mailing Address - Zip Code:69218-0184
Mailing Address - Country:US
Mailing Address - Phone:308-207-2300
Mailing Address - Fax:605-646-4828
Practice Address - Street 1:32518 W PIONEER SCHOOL RD
Practice Address - Street 2:
Practice Address - City:MERRIMAN
Practice Address - State:NE
Practice Address - Zip Code:69218-6563
Practice Address - Country:US
Practice Address - Phone:605-646-3786
Practice Address - Fax:605-646-4828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-18
Last Update Date:2024-01-23
Deactivation Date:2023-11-27
Deactivation Code:
Reactivation Date:2023-12-04
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026763100Medicaid
NE10026763102Medicaid
NE10026763101Medicaid