Provider Demographics
NPI:1710697503
Name:NEUROPATHWAYS COUNSELING LLC
Entity Type:Organization
Organization Name:NEUROPATHWAYS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:EVE
Authorized Official - Last Name:IRWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-204-1345
Mailing Address - Street 1:222 1ST AVE SW STE 210
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-2573
Mailing Address - Country:US
Mailing Address - Phone:541-204-1345
Mailing Address - Fax:541-204-0339
Practice Address - Street 1:222 1ST AVE SW STE 210
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2573
Practice Address - Country:US
Practice Address - Phone:541-204-1345
Practice Address - Fax:541-204-0339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-02
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR128715Medicaid