Healthcare Provider Details

I. General information

NPI: 1033086178
Provider Name (Legal Business Name): MID PATH COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2025
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2242 LANDAN DR
LOUISVILLE KY
40218-1506
US

IV. Provider business mailing address

2242 LANDAN DR
LOUISVILLE KY
40218-1506
US

V. Phone/Fax

Practice location:
  • Phone: 502-510-0713
  • Fax: 931-901-1239
Mailing address:
  • Phone: 502-510-0713
  • Fax: 931-901-1239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PAMELA A REINERS
Title or Position: CREDENTIALING
Credential:
Phone: 731-571-9223