Healthcare Provider Details

I. General information

NPI: 1053111369
Provider Name (Legal Business Name): PATHFINDERS BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 03/17/2025
Certification Date: 03/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 N BAXTER ST
COQUILLE OR
97423-1826
US

IV. Provider business mailing address

PO BOX 174
COQUILLE OR
97423-0174
US

V. Phone/Fax

Practice location:
  • Phone: 541-404-4542
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. GREGORY GARROW
Title or Position: OWNER / MANAGER
Credential: LCSW
Phone: 541-404-4542