Provider Demographics
NPI:1750161295
Name:ONYX PATHWAYS, LLC
Entity type:Organization
Organization Name:ONYX PATHWAYS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIERRA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:952-856-0405
Mailing Address - Street 1:12800 WHITEWATER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-9347
Mailing Address - Country:US
Mailing Address - Phone:952-856-0405
Mailing Address - Fax:
Practice Address - Street 1:12800 WHITEWATER DR STE 100
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-9347
Practice Address - Country:US
Practice Address - Phone:952-856-0405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-03
Last Update Date:2024-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty