Healthcare Provider Details

I. General information

NPI: 1649109687
Provider Name (Legal Business Name): PATHWAYS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 MAIN ST
DELTA CO
81416-1853
US

IV. Provider business mailing address

1025 MAIN ST
DELTA CO
81416-1853
US

V. Phone/Fax

Practice location:
  • Phone: 304-932-0737
  • Fax:
Mailing address:
  • Phone: 304-932-0737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: LEIGH ANNE SUPPES
Title or Position: OWNER/CEO
Credential:
Phone: 304-932-0737