Healthcare Provider Details

I. General information

NPI: 1205730132
Provider Name (Legal Business Name): PATHWAYS TO GRACE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13146 QUIET WOODS RD APT A
WELLINGTON FL
33414-2912
US

IV. Provider business mailing address

11987 SOUTHERN BLVD UNIT 2
ROYAL PALM BEACH FL
33411-7619
US

V. Phone/Fax

Practice location:
  • Phone: 561-412-5057
  • Fax:
Mailing address:
  • Phone: 561-412-5057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: LINDA PERVENECKI
Title or Position: OWNER
Credential: LMHC
Phone: 561-412-5057