Provider Demographics
NPI:1821547605
Name:PATHWAY TO HEALING, MARRIAGE AND FAMILY THERAPY, INC.
Entity Type:Organization
Organization Name:PATHWAY TO HEALING, MARRIAGE AND FAMILY THERAPY, INC.
Other - Org Name:PATHWAY TO RELATIONAL & INNER HEALING MARRIAGE & FAMILY THERAPY, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:CARVER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:951-289-9900
Mailing Address - Street 1:5790 MAGNOLIA AVE, STE 202, RM F
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506
Mailing Address - Country:US
Mailing Address - Phone:951-289-9900
Mailing Address - Fax:951-682-0519
Practice Address - Street 1:5790 MAGNOLIA AVE., STE 202, RM F
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506
Practice Address - Country:US
Practice Address - Phone:951-289-9900
Practice Address - Fax:951-682-0519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty