Provider Demographics
NPI:1922779065
Name:PATHWAYS THERAPY SERVICE LLC
Entity Type:Organization
Organization Name:PATHWAYS THERAPY SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING/SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:915-201-0675
Mailing Address - Street 1:1505 GEORGE DIETER DR STE 109-509
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-7660
Mailing Address - Country:US
Mailing Address - Phone:915-201-0675
Mailing Address - Fax:915-232-9816
Practice Address - Street 1:500 N OREGON ST FL 2
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79901-1121
Practice Address - Country:US
Practice Address - Phone:915-201-0675
Practice Address - Fax:915-232-9816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)