Provider Demographics
NPI:1619451317
Name:A PATHWAY TO LIFE COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:A PATHWAY TO LIFE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ADDCITION COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WILLIAMS-RODRIGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-462-1302
Mailing Address - Street 1:PO BOX 74653
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70033-4653
Mailing Address - Country:US
Mailing Address - Phone:504-462-1302
Mailing Address - Fax:
Practice Address - Street 1:225 SHREWSBURY RD
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:LA
Practice Address - Zip Code:70121-3523
Practice Address - Country:US
Practice Address - Phone:504-462-1302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty