Provider Demographics
NPI:1710381587
Name:PATHWAYS BEHAVIORAL SERVICES
Entity Type:Organization
Organization Name:PATHWAYS BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:REITER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CADC
Authorized Official - Phone:319-334-6163
Mailing Address - Street 1:PO BOX 7
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:IA
Mailing Address - Zip Code:50644-0007
Mailing Address - Country:US
Mailing Address - Phone:319-334-6163
Mailing Address - Fax:
Practice Address - Street 1:209 2ND AVE NE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:IA
Practice Address - Zip Code:50644-1904
Practice Address - Country:US
Practice Address - Phone:319-334-6163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA008278251S00000X
IA09053251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health