Healthcare Provider Details

I. General information

NPI: 1275461261
Provider Name (Legal Business Name): PATHWAYS TO COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 COURT ST # 5TH
BOSTON MA
02108-2202
US

IV. Provider business mailing address

40 COURT ST # 5TH
BOSTON MA
02108-2202
US

V. Phone/Fax

Practice location:
  • Phone: 617-693-1188
  • Fax:
Mailing address:
  • Phone: 617-693-1188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SHELANA SIMON
Title or Position: PRESIDENT
Credential: LICSW
Phone: 617-693-1188