Healthcare Provider Details

I. General information

NPI: 1588256879
Provider Name (Legal Business Name): PATHWAY PSYCHIATRY & COUNSELING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2021
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 GEORGE ST STE 100
BECKLEY WV
25801-2653
US

IV. Provider business mailing address

310 GEORGE ST STE 100
BECKLEY WV
25801-2653
US

V. Phone/Fax

Practice location:
  • Phone: 681-238-3344
  • Fax: 681-207-3653
Mailing address:
  • Phone: 681-238-3344
  • Fax: 681-207-3653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: PEGGY L GARRETT
Title or Position: OFFICE MANAGER
Credential:
Phone: 681-207-3652