Healthcare Provider Details

I. General information

NPI: 1497616601
Provider Name (Legal Business Name): PATHWAYS COMMUNITY MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W SPRING ST
MARQUETTE MI
49855-4661
US

IV. Provider business mailing address

200 W SPRING ST
MARQUETTE MI
49855-4661
US

V. Phone/Fax

Practice location:
  • Phone: 906-233-1236
  • Fax: 906-233-1235
Mailing address:
  • Phone: 906-233-1236
  • Fax: 906-233-1235

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: THERESA SHEPARD
Title or Position: BILLING CLERK
Credential:
Phone: 906-233-1236