Healthcare Provider Details

I. General information

NPI: 1639026099
Provider Name (Legal Business Name): PATHWAYS TO RENEWAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 LAKE DR
LAUREL DE
19956-1707
US

IV. Provider business mailing address

115 LAKE DR
LAUREL DE
19956-1707
US

V. Phone/Fax

Practice location:
  • Phone: 302-396-9114
  • Fax:
Mailing address:
  • Phone: 302-396-9114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. ERICA J PERSAUD
Title or Position: SOLE MEMBER
Credential: LPCMH, LCDC
Phone: 302-396-9114