Provider Demographics
NPI:1780564070
Name:EMPATHIC PATHWAYS BEHAVIORAL AND MENTAL HEALTH FOUNDATION
Entity type:Organization
Organization Name:EMPATHIC PATHWAYS BEHAVIORAL AND MENTAL HEALTH FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAILA
Authorized Official - Middle Name:ELISA
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:619-722-0686
Mailing Address - Street 1:2535 ALPINE BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:CA
Mailing Address - Zip Code:91901-2395
Mailing Address - Country:US
Mailing Address - Phone:619-722-0686
Mailing Address - Fax:
Practice Address - Street 1:2535 ALPINE BLVD STE 1
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:CA
Practice Address - Zip Code:91901-2395
Practice Address - Country:US
Practice Address - Phone:619-722-0686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty