Provider Demographics
NPI:1952061160
Name:PATHFINDER COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:PATHFINDER COUNSELING SERVICES, LLC
Other - Org Name:PATHFINDER COUNSELING SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MANISH
Authorized Official - Middle Name:B
Authorized Official - Last Name:GAUR
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:720-713-9183
Mailing Address - Street 1:2919 17TH AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-1657
Mailing Address - Country:US
Mailing Address - Phone:720-713-9183
Mailing Address - Fax:
Practice Address - Street 1:2919 17TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-1657
Practice Address - Country:US
Practice Address - Phone:303-651-6769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-29
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1154628964Medicaid