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General NPI Number Information
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NPI Number | 1023823887
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Entity Type | Organization
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Legal Business Name | PATH FORWARD COUNSELING LLC
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 11806 ABERDEEN ST NE STE 220
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City | BLAINE
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State | MN
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Zip | 55449-4712
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Country | US
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Telephone | 763-913-7076
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Fax |
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Provider Business Mailing Address
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Address Line | 6349 WINNETKA AVE N
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City | BROOKLYN PARK
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State | MN
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Zip | 55428-2163
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Country | US
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Telephone | 763-913-7076
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL SOCIAL WORKER
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Name | MICHELLE NICOLE FERREL
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Credential | MSW, LICSW
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Telephone | 612-541-7106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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