Healthcare Provider Details

I. General information

NPI: 1285305508
Provider Name (Legal Business Name): PATHWAYS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2021
Last Update Date: 09/27/2021
Certification Date: 08/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 MAIN ST STE 203
PRINCE FREDERICK MD
20678-6111
US

IV. Provider business mailing address

PO BOX 129
HOLLYWOOD MD
20636-0129
US

V. Phone/Fax

Practice location:
  • Phone: 301-373-3065
  • Fax: 240-309-4131
Mailing address:
  • Phone: 301-373-3065
  • Fax: 240-309-4131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AMANDA M MULLINS
Title or Position: CLINIC OPERATIONAL MANAGER
Credential:
Phone: 301-373-3065