Provider Demographics
NPI:1760450837
Name:PATHWAYS COUNSELING AND GROWTH CENTER
Entity Type:Organization
Organization Name:PATHWAYS COUNSELING AND GROWTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LASECKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-323-5707
Mailing Address - Street 1:312 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-5618
Mailing Address - Country:US
Mailing Address - Phone:440-323-5707
Mailing Address - Fax:440-323-3016
Practice Address - Street 1:312 3RD ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-5618
Practice Address - Country:US
Practice Address - Phone:440-323-5707
Practice Address - Fax:440-323-3016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH10635Medicaid