Provider Demographics
NPI:1588220768
Name:POSITIVE PATHWAYS COUNSELING AND BEHAVIORAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:POSITIVE PATHWAYS COUNSELING AND BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:804-833-6320
Mailing Address - Street 1:PO BOX 653
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:VA
Mailing Address - Zip Code:24592-0653
Mailing Address - Country:US
Mailing Address - Phone:804-833-6320
Mailing Address - Fax:
Practice Address - Street 1:554 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:VA
Practice Address - Zip Code:24592-3206
Practice Address - Country:US
Practice Address - Phone:804-833-6320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health