Provider Demographics
NPI:1598059859
Name:EMERGING PATHWAYS, LLC
Entity Type:Organization
Organization Name:EMERGING PATHWAYS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELISABETH
Authorized Official - Last Name:BEIKIRCH-GODWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC, CAP
Authorized Official - Phone:863-640-2807
Mailing Address - Street 1:5110 S FLORIDA AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2512
Mailing Address - Country:US
Mailing Address - Phone:863-640-2807
Mailing Address - Fax:863-510-5903
Practice Address - Street 1:5110 S FLORIDA AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2512
Practice Address - Country:US
Practice Address - Phone:863-640-2807
Practice Address - Fax:863-510-5903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-04
Last Update Date:2011-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8009101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X
FLCAP4269101YA0400X
FL651278101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty