Healthcare Provider Details
I. General information
NPI: 1750125068
Provider Name (Legal Business Name): PATHWAYS SUMMIT COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/21/2024
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2446 ROSEWOOD N
MT PLEASANT MI
48858-5003
US
IV. Provider business mailing address
2446 ROSEWOOD N
MT PLEASANT MI
48858-5003
US
V. Phone/Fax
- Phone: 989-513-2311
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHELLE
HARRAST
Title or Position: OWNER
Credential:
Phone: 989-513-2311