Provider Demographics
NPI:1720540776
Name:PATHWAYS COUNSELING OF SARATOGA, PC
Entity Type:Organization
Organization Name:PATHWAYS COUNSELING OF SARATOGA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ETKIN-SEFCOL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:518-313-0004
Mailing Address - Street 1:222 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-3619
Mailing Address - Country:US
Mailing Address - Phone:518-313-0004
Mailing Address - Fax:
Practice Address - Street 1:15 MAPLE DELL STE 3
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2953
Practice Address - Country:US
Practice Address - Phone:518-313-0004
Practice Address - Fax:518-581-8783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY180400108Medicaid