Healthcare Provider Details

I. General information

NPI: 1841123213
Provider Name (Legal Business Name): PATHWAY TO PEACE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 BRICK BLVD STE 204
BRICK NJ
08723-6079
US

IV. Provider business mailing address

1173 LAUREL DR
TOMS RIVER NJ
08753-3173
US

V. Phone/Fax

Practice location:
  • Phone: 732-996-7431
  • Fax:
Mailing address:
  • Phone: 732-996-7431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KELLY A RAFTER
Title or Position: OWNER
Credential: LPC, ACS
Phone: 732-996-7431