Provider Demographics
NPI:1871033035
Name:PATHWAYS TO THE HEART: SEXUALITY, INTIMACY, & RELATIONAL THERAPY LLC
Entity Type:Organization
Organization Name:PATHWAYS TO THE HEART: SEXUALITY, INTIMACY, & RELATIONAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEFUS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-941-1739
Mailing Address - Street 1:35 BOSTON ST
Mailing Address - Street 2:SHORELINE CENTER FOR WHOLISTIC HEALTH ATTN:ASHLIE BEFUS
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2817
Mailing Address - Country:US
Mailing Address - Phone:203-941-1739
Mailing Address - Fax:
Practice Address - Street 1:35 BOSTON ST
Practice Address - Street 2:SHORELINE CENTER FOR WHOLISTIC HEALTH ATTN:ASHLIE BEFUS
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2817
Practice Address - Country:US
Practice Address - Phone:203-941-1739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001564106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1104055433OtherPERSONAL NPI
001564OtherSTATE LICENCE NUMBER
CT008042953OtherMEDICAID