Provider Demographics
NPI:1962643114
Name:PATHWAYS COUNSELING CENTER
Entity Type:Organization
Organization Name:PATHWAYS COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHI
Authorized Official - Middle Name:D
Authorized Official - Last Name:BARZILAUSKAS
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:812-339-9980
Mailing Address - Street 1:3866 W. THIRD STREET
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47404
Mailing Address - Country:US
Mailing Address - Phone:812-330-1477
Mailing Address - Fax:812-330-8755
Practice Address - Street 1:3866 W. THIRD STREET
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404
Practice Address - Country:US
Practice Address - Phone:812-330-1477
Practice Address - Fax:812-330-8755
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIRST HEALTH CARE GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000882A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200088980Medicaid
IN200088980Medicaid