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NPI Code Detail

MEDICARE: PATHLIGHT NEUROPSYCHIATRIC CENTER

MEDICARE: PATHLIGHT NEUROPSYCHIATRIC CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2101YM0800XMental Health Counselor
3101YP2500XProfessional Counselor
4103T00000XPsychologist
5103TC0700XClinical Psychologist
6103TC2200XClinical Child & Adolescent Psychologist
7103TF0000XFamily Psychologist
8103TP2701XGroup Psychotherapy Psychologist
9104100000XSocial Worker
101041C0700XClinical Social Worker
112084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1023837937
Entity Type Code : Organization
Provider Name (Legal Business Name) : PATHLIGHT NEUROPSYCHIATRIC CENTER
Provider Business Mailing Address
First Line : PO BOX 560901
Second Line :
City : DENVER
State : CO
Zip : 80256-0901
Country : US
Telephone Number : 877-825-8584
Fax Number :
Provider Business Practice Location Address
First Line : 3610 AMERICAN RIVER DR STE 140
Second Line :
City : SACRAMENTO
State : CA
Zip : 95864-5919
Country : US
Telephone Number : 877-825-8584
Fax Number :
Authorized Official
Title or Position : INSURANCE CREENTIALING SUPERVISOR
Name : JESS JOSLIN
Credential :
Telephone Number : 918-766-8217
Provider Enumeration Date : 10/08/2024
Last Update Date : 10/08/2024

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Directions to “PATHLIGHT NEUROPSYCHIATRIC CENTER ” Practice Location

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