Provider Demographics
NPI:1437580495
Name:HEALING PATHWAYS THERAPY CENTER
Entity Type:Organization
Organization Name:HEALING PATHWAYS THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARNICK
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC
Authorized Official - Phone:801-867-8112
Mailing Address - Street 1:2657 S JASPER ST
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-2207
Mailing Address - Country:US
Mailing Address - Phone:801-867-8112
Mailing Address - Fax:801-649-5651
Practice Address - Street 1:1174 E GRAYSTONE WAY
Practice Address - Street 2:SUITE 6
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-2673
Practice Address - Country:US
Practice Address - Phone:801-867-8112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5533760-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty