Healthcare Provider Details

I. General information

NPI: 1336098763
Provider Name (Legal Business Name): FIREPATH COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2026
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 BIRD AVE (417)-529-5249
JOPLIN MO
64804-1824
US

IV. Provider business mailing address

101 N MAIN ST PO BOX #101
JOPLIN MO
64802-2201
US

V. Phone/Fax

Practice location:
  • Phone: 417-318-7573
  • Fax:
Mailing address:
  • Phone: 417-318-7573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN P LIVESAY
Title or Position: OWNER
Credential: LCSW
Phone: 417-318-7573