Provider Demographics
NPI:1851894224
Name:A STRAIGHT PATH COUNSELING PLLC
Entity Type:Organization
Organization Name:A STRAIGHT PATH COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIVENS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:601-466-2186
Mailing Address - Street 1:2400 HIGHWAY 56
Mailing Address - Street 2:
Mailing Address - City:CHATOM
Mailing Address - State:AL
Mailing Address - Zip Code:36518-6600
Mailing Address - Country:US
Mailing Address - Phone:251-847-3914
Mailing Address - Fax:
Practice Address - Street 1:906 SPRING ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:MS
Practice Address - Zip Code:39367-2424
Practice Address - Country:US
Practice Address - Phone:601-466-2186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1961101YM0800X
AL3454101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty