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General NPI Number Information
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NPI Number | 1003700527
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Entity Type | Organization
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Legal Business Name | LIFE'S PATHWAY: THERAPEUTIC SERVICES
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 114 HAMLET CIR
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City | MONTGOMERY
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State | IL
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Zip | 60538-3024
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Country | US
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Telephone | 630-802-8376
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Fax |
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Provider Business Mailing Address
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Address Line | 114 HAMLET CIR
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City | MONTGOMERY
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State | IL
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Zip | 60538-3024
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Country | US
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Telephone | 630-802-8376
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Fax |
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Authorized Official
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Title or Position | OWNER / CLINICAL THERAPIST
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Name | MR. JOHNATHAN PHILIP DUNN
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Credential | LCPC
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Telephone | 630-802-8376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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