Healthcare Provider Details

I. General information

NPI: 1316657653
Provider Name (Legal Business Name): PATHWAYS PSYCHOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2022
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HABERSHAM DR
YOUNGSVILLE LA
70592-5116
US

IV. Provider business mailing address

4400 AMBASSADOR CAFFERY PKWY STE A
LAFAYETTE LA
70508-6760
US

V. Phone/Fax

Practice location:
  • Phone: 336-524-1628
  • Fax: 336-792-5896
Mailing address:
  • Phone: 336-524-1628
  • Fax: 336-792-5896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. CRISTIN MARIE SAFFO
Title or Position: OWNER/SOLE MEMBER
Credential: PSYD
Phone: 336-524-1628