=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275159329
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PASSAGEWAYS COUNSELING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/24/2020
-----------------------------------------------------
Last Update Date | 08/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 52 PINE CREEK ROAD SUITE 200
-----------------------------------------------------
City | WEXFORD
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15090-9366
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-965-3123
-----------------------------------------------------
Fax | 878-999-8197
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 52 PINE CREEK ROAD SUITE 200
-----------------------------------------------------
City | WEXFORD
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15090-9366
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-965-3123
-----------------------------------------------------
Fax | 878-999-8197
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL PSYCHOLOGIST/OWNER
-----------------------------------------------------
Name | JENNIFER JO ELDRIDGE
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 724-719-7603
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------