Healthcare Provider Details

I. General information

NPI: 1811517147
Provider Name (Legal Business Name): PATHS TO EMPOWERMENT COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2020
Last Update Date: 04/17/2020
Certification Date: 04/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7850 COUNTRY DR
MOBILE AL
36619-5325
US

IV. Provider business mailing address

9339 MCFARLAND WAY
MOBILE AL
36695-6909
US

V. Phone/Fax

Practice location:
  • Phone: 251-604-8325
  • Fax: 251-635-0997
Mailing address:
  • Phone: 251-604-8325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARILYN JOHNSON-NELSON
Title or Position: PROVIDER
Credential:
Phone: 251-604-8325