Provider Demographics
NPI:1689094112
Name:PATHWAY COUNSELING CENTER
Entity Type:Organization
Organization Name:PATHWAY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:D
Authorized Official - Last Name:FLOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:319-804-1004
Mailing Address - Street 1:1073 ROCKFORD RD SE
Mailing Address - Street 2:SUITE E
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404
Mailing Address - Country:US
Mailing Address - Phone:319-804-1004
Mailing Address - Fax:
Practice Address - Street 1:1073 ROCKFORD RD SE
Practice Address - Street 2:SUITE E
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404
Practice Address - Country:US
Practice Address - Phone:319-804-1004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001597261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)