Provider Demographics
NPI:1033086178
Name:MID PATH COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:MID PATH COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:A
Authorized Official - Last Name:REINERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-571-9223
Mailing Address - Street 1:2242 LANDAN DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-1506
Mailing Address - Country:US
Mailing Address - Phone:502-510-0713
Mailing Address - Fax:931-901-1239
Practice Address - Street 1:2242 LANDAN DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-1506
Practice Address - Country:US
Practice Address - Phone:502-510-0713
Practice Address - Fax:931-901-1239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7101049840Medicaid