Healthcare Provider Details

I. General information

NPI: 1790938140
Provider Name (Legal Business Name): HEALING PATHWAYS COUNSELING & CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2008
Last Update Date: 10/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12090 WINDSOR SOUTH DR
FISHERS IN
46038-3056
US

IV. Provider business mailing address

P.O. BOX 6055
FISHERS IN
46038
US

V. Phone/Fax

Practice location:
  • Phone: 317-509-5727
  • Fax:
Mailing address:
  • Phone: 317-509-5727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. DA'KISHA L. PARKER
Title or Position: OWNER, CEO
Credential: M.A., MFT
Phone: 317-509-5727