Provider Demographics
NPI:1326913633
Name:PATHWAYS TO RISE ABOVE
Entity type:Organization
Organization Name:PATHWAYS TO RISE ABOVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:R
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-661-6663
Mailing Address - Street 1:2016 MILLERTON AVE APT 2313
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-5110
Mailing Address - Country:US
Mailing Address - Phone:312-661-6663
Mailing Address - Fax:
Practice Address - Street 1:2016 MILLERTON AVE APT 2313
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-5110
Practice Address - Country:US
Practice Address - Phone:312-661-6663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health