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General NPI Number Information
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NPI Number | 1336941533
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Entity Type | Organization
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Legal Business Name | PATHWAY MINISTRIES
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 1831 N KNOXVILLE AVE
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City | PEORIA
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State | IL
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Zip | 61603-3027
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Country | US
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Telephone | 309-688-9282
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Fax |
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Provider Business Mailing Address
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Address Line | 601 SW ADAMS ST
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City | PEORIA
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State | IL
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Zip | 61602-1523
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Country | US
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Telephone | 309-676-6416
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JONATHAN ROCKE
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Credential |
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Telephone | 309-676-6416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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