Healthcare Provider Details

I. General information

NPI: 1629866447
Provider Name (Legal Business Name): RENEWED PATHWAYS BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2025
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3741 WESTERRE PKWY STE B
HENRICO VA
23233-1327
US

IV. Provider business mailing address

9829 KINGSROCK LN
MECHANICSVILLE VA
23116-8727
US

V. Phone/Fax

Practice location:
  • Phone: 571-736-3933
  • Fax: 804-429-2429
Mailing address:
  • Phone: 571-736-3933
  • Fax: 804-429-2429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHAVONNIE ZIMMERMAN
Title or Position: OWNER
Credential:
Phone: 571-736-3933