Healthcare Provider Details

I. General information

NPI: 1689152498
Provider Name (Legal Business Name): PURPOSEFUL PATHWAY CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2018
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 S MAIN ST STE B106
PENNINGTON NJ
08534-2821
US

IV. Provider business mailing address

PO BOX 416
FAIRLESS HILLS PA
19030-0416
US

V. Phone/Fax

Practice location:
  • Phone: 609-429-6596
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. ANNIESHA WALKER
Title or Position: CEO, CLINICAL DIRECTOR
Credential: DSW, LCSW
Phone: 609-429-6596