Provider Demographics
NPI:1902388432
Name:PATHLIGHT COUNSELING LLC
Entity Type:Organization
Organization Name:PATHLIGHT COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BRITTIAN
Authorized Official - Last Name:PARRAMORE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CAADC
Authorized Official - Phone:678-568-2285
Mailing Address - Street 1:4390 EARNEY RD STE 140
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-5687
Mailing Address - Country:US
Mailing Address - Phone:706-675-5241
Mailing Address - Fax:706-553-4157
Practice Address - Street 1:4390 EARNEY RD STE 140
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-5687
Practice Address - Country:US
Practice Address - Phone:706-675-5241
Practice Address - Fax:706-553-4157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-31
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty