Provider Demographics
NPI:1508267139
Name:PATHWAYS BEHAVIORAL CONSULTING, LLC
Entity Type:Organization
Organization Name:PATHWAYS BEHAVIORAL CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND FOUNDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:CRISSEY
Authorized Official - Last Name:LAMONT
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA
Authorized Official - Phone:571-228-5969
Mailing Address - Street 1:2472 JETT FERRY RD STE 400-197
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-3059
Mailing Address - Country:US
Mailing Address - Phone:404-465-1818
Mailing Address - Fax:
Practice Address - Street 1:2472 JETT FERRY RD STE 400-197
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-3059
Practice Address - Country:US
Practice Address - Phone:404-465-1818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-10-6841251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health