Provider Demographics
NPI:1942562665
Name:PATHWAYS THERAPY AND WELLNESS CENTER
Entity Type:Organization
Organization Name:PATHWAYS THERAPY AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MFT-I
Authorized Official - Prefix:MISS
Authorized Official - First Name:BRANDYE
Authorized Official - Middle Name:
Authorized Official - Last Name:TINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-944-7148
Mailing Address - Street 1:2298 W. HORIZON RIDGE PKWY
Mailing Address - Street 2:STE 201
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052
Mailing Address - Country:US
Mailing Address - Phone:702-363-7284
Mailing Address - Fax:702-242-5252
Practice Address - Street 1:2298 W. HORIZON RIDGE PARKWAY
Practice Address - Street 2:STE 201
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052
Practice Address - Country:US
Practice Address - Phone:702-363-7284
Practice Address - Fax:702-242-5252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI0351251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health