Provider Demographics
NPI:1962036194
Name:PATHWAYS TO PEACE PSYCHOTHERAPY CENTER INCORPORATED
Entity Type:Organization
Organization Name:PATHWAYS TO PEACE PSYCHOTHERAPY CENTER INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARYANN
Authorized Official - Middle Name:REUTER
Authorized Official - Last Name:KAIRYS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-231-7291
Mailing Address - Street 1:3625 E THOUSAND OAKS BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-3566
Mailing Address - Country:US
Mailing Address - Phone:818-231-7291
Mailing Address - Fax:
Practice Address - Street 1:3625 E THOUSAND OAKS BLVD STE 209
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3566
Practice Address - Country:US
Practice Address - Phone:818-231-7291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty