Provider Demographics
NPI:1942985569
Name:PEACEFUL PATHWAYS THERAPEUTIC SERVICES, PLLC
Entity Type:Organization
Organization Name:PEACEFUL PATHWAYS THERAPEUTIC SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMESHA
Authorized Official - Middle Name:GODDARD
Authorized Official - Last Name:RHYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-213-3204
Mailing Address - Street 1:2309 W CONE BLVD STE 240A
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-4047
Mailing Address - Country:US
Mailing Address - Phone:910-213-3204
Mailing Address - Fax:336-398-3825
Practice Address - Street 1:2309 W CONE BLVD STE 240A
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-4047
Practice Address - Country:US
Practice Address - Phone:910-213-3204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)