Provider Demographics
NPI:1710683289
Name:PATHWAY TO PEACE PSYCHOTHERAPY PLLC
Entity Type:Organization
Organization Name:PATHWAY TO PEACE PSYCHOTHERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SAPP
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:574-612-5164
Mailing Address - Street 1:12222 N PARADISE VILLAGE PKWY S APT 207
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-7676
Mailing Address - Country:US
Mailing Address - Phone:574-612-5164
Mailing Address - Fax:
Practice Address - Street 1:10000 N 31ST AVE STE D214
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-2001
Practice Address - Country:US
Practice Address - Phone:574-612-5164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty