Healthcare Provider Details

I. General information

NPI: 1588593719
Provider Name (Legal Business Name): MINDFUL PATHWAYS COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5427 PETERS CREEK RD STE H
ROANOKE VA
24019-3858
US

IV. Provider business mailing address

5247 PETERS CREEK RD NW STE H
ROANOKE VA
24019-3858
US

V. Phone/Fax

Practice location:
  • Phone: 877-817-0543
  • Fax:
Mailing address:
  • Phone: 877-817-0543
  • Fax: 877-748-9496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA MORRIS
Title or Position: OWNER
Credential: LPC
Phone: 540-529-0173