Provider Demographics
NPI:1942644547
Name:HEALING PATHWAYS PLLC
Entity Type:Organization
Organization Name:HEALING PATHWAYS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:HAZEL
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:MCRAE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:713-515-0069
Mailing Address - Street 1:651 N HIGHWAY 183
Mailing Address - Street 2:SUITE 335-56
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-7001
Mailing Address - Country:US
Mailing Address - Phone:713-515-0069
Mailing Address - Fax:979-830-1693
Practice Address - Street 1:1403 LIVE OAK RD
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-8420
Practice Address - Country:US
Practice Address - Phone:713-515-0069
Practice Address - Fax:979-830-1693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-25
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12963101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX113045203Medicaid