Healthcare Provider Details

I. General information

NPI: 1871413658
Provider Name (Legal Business Name): PATHWAY TO PEACE & HEALING THERAPY, P.L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 E REID RD STE 211
GRAND BLANC MI
48439-2416
US

IV. Provider business mailing address

210 E REID RD STE 211
GRAND BLANC MI
48439-2416
US

V. Phone/Fax

Practice location:
  • Phone: 801-400-4809
  • Fax:
Mailing address:
  • Phone: 801-400-4809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JILL EVON PARR
Title or Position: CLINICAL SOCIAL WORKER
Credential: LMSW/LCSW
Phone: 801-400-4809