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NPI Code Detail

MEDICARE: RESTORATIVE PATHWAYS COUNSELING, LLC

MEDICARE: RESTORATIVE PATHWAYS COUNSELING, 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
11041C0700XClinical Social Worker
2101Y00000XCounselor
3101YM0800XMental Health Counselor
4104100000XSocial Worker
5251B00000XCase Management Agency
6251S00000XCommunity/Behavioral Health Agency
7261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215408000
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESTORATIVE PATHWAYS COUNSELING, LLC
Provider Business Mailing Address
First Line : PO BOX 3103
Second Line :
City : ZANESVILLE
State : OH
Zip : 43702-3103
Country : US
Telephone Number : 740-704-5067
Fax Number :
Provider Business Practice Location Address
First Line : 58 N 5TH ST STE 102
Second Line :
City : ZANESVILLE
State : OH
Zip : 43701-3527
Country : US
Telephone Number : 740-214-6443
Fax Number : 888-626-6496
Authorized Official
Title or Position : EXECUTIVE DIRECTOR, OWNER
Name : MIRANDA WALTON
Credential : MA, LPCC-S
Telephone Number : 740-704-5067
Provider Enumeration Date : 12/06/2018
Last Update Date : 09/07/2023

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