Provider Demographics
NPI:1952945412
Name:PATHS MENTAL HEALTH, LLC
Entity Type:Organization
Organization Name:PATHS MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DORIMARIES
Authorized Official - Middle Name:
Authorized Official - Last Name:NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:MENTAL HEALTH MA
Authorized Official - Phone:813-850-1966
Mailing Address - Street 1:4854 SAN PABLO PL
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-6253
Mailing Address - Country:US
Mailing Address - Phone:813-850-1966
Mailing Address - Fax:
Practice Address - Street 1:4854 SAN PABLO PL
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-6253
Practice Address - Country:US
Practice Address - Phone:813-850-1966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty