Healthcare Provider Details

I. General information

NPI: 1043083942
Provider Name (Legal Business Name): PATHWAYS TO WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2023
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 GERMANTOWN CT, SUITE 207
CORDOVA TN
38018-4258
US

IV. Provider business mailing address

65 GERMANTOWN CT 207
CORDOVA TN
38018-4258
US

V. Phone/Fax

Practice location:
  • Phone: 901-878-3332
  • Fax: 901-350-7790
Mailing address:
  • Phone: 901-878-3332
  • Fax: 901-350-7790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOHN PEARSON REDMOND
Title or Position: CEO
Credential: APRN
Phone: 901-870-0258