Healthcare Provider Details

I. General information

NPI: 1639212103
Provider Name (Legal Business Name): PAHWAYS OF DELAWARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 06/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 ROGERS RD. SUITE 102
WILMINGTON DE
19801
US

IV. Provider business mailing address

101 ROGERS RD. SUITE 102
WILMINGTON DE
19801
US

V. Phone/Fax

Practice location:
  • Phone: 302-573-5073
  • Fax: 302-573-5072
Mailing address:
  • Phone: 302-573-5073
  • Fax: 302-573-5072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC-0000785
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberPC-103K00000X
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberPC-0000803
License Number StateDE
# 4
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License NumberPC-0000803
License Number StateDE
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0001015
License Number StateDE
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0001507
License Number StateDE
# 7
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0001173
License Number StateDE

VIII. Authorized Official

Name: MS. SHARON RICHEY
Title or Position: ADMIN. ASST./BILLER
Credential:
Phone: 302-573-5073