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General NPI Number Information
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NPI Number | 1013778034
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Entity Type | Organization
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Legal Business Name | PATHWAYS MENTAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 01/17/2024
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 223 MINERAL ST
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City | NEWPORT
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State | TN
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Zip | 37821-3827
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Country | US
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Telephone | 423-226-5431
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Fax |
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Provider Business Mailing Address
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Address Line | 7467 ARMORY RD
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City | NEWPORT
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State | TN
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Zip | 37821-6781
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Country | US
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Telephone | 865-322-1953
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Fax |
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Authorized Official
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Title or Position | OWNER AND PMHNP
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Name | CRYSTAL LANE
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Credential | MSN, APRN, PMHNP-BC
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Telephone | 865-322-1953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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