Provider Demographics
NPI:1497506109
Name:GLOWING PATHWAYS COUNSELING
Entity Type:Organization
Organization Name:GLOWING PATHWAYS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:505-639-0922
Mailing Address - Street 1:10242 COORS BYPASS NW UNIT 1060
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-4088
Mailing Address - Country:US
Mailing Address - Phone:505-639-0922
Mailing Address - Fax:
Practice Address - Street 1:333 RIO RANCHO BLVD NE STE 301A
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1456
Practice Address - Country:US
Practice Address - Phone:505-585-2552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health