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NPI Code Detail

MEDICARE: KBX PATHWAYS TO WELLNESS LLC

MEDICARE: KBX PATHWAYS TO WELLNESS LLC
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1174466999
Entity Type Code : Organization
Provider Name (Legal Business Name) : KBX PATHWAYS TO WELLNESS LLC
Provider Business Mailing Address
First Line : 4030 WAKE FOREST RD STE 349
Second Line :
City : RALEIGH
State : NC
Zip : 27609-0010
Country : US
Telephone Number : 919-539-8762
Fax Number :
Provider Business Practice Location Address
First Line : 4030 WAKE FOREST RD STE 349
Second Line :
City : RALEIGH
State : NC
Zip : 27609-0010
Country : US
Telephone Number : 919-539-8762
Fax Number :
Authorized Official
Title or Position : CLINICAL DIRECTOR
Name : KENI CHURCH-HINES
Credential : LCMHC
Telephone Number : 984-385-2650
Provider Enumeration Date : 04/14/2026
Last Update Date : 04/14/2026

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Directions to “KBX PATHWAYS TO WELLNESS LLC ” Practice Location

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