Healthcare Provider Details

I. General information

NPI: 1689021925
Provider Name (Legal Business Name): HEALING PATHWAYS COUNSELING AND CONSULTING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2016
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 MIDDLEFORD ROAD SUITE 102
SEAFOND DE
19973-3670
US

IV. Provider business mailing address

1310 MIDDLEFORD ROAD SUITE 102
SEAFOND DE
19973-3670
US

V. Phone/Fax

Practice location:
  • Phone: 302-536-1395
  • Fax: 302-536-7498
Mailing address:
  • Phone: 302-536-1395
  • Fax: 302-536-7498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. SUSAN R BENNETT
Title or Position: MEMBER LLC/OWNER
Credential: LPCMH
Phone: 302-536-1395