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General NPI Number Information
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NPI Number | 1386706893
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Entity Type | Organization
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Legal Business Name | POSITIVE PATHWAYS LLC
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 800 COMPTON RD UNIT 12
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City | CINCINNATI
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State | OH
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Zip | 45231-3846
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Country | US
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Telephone | 513-521-3175
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Fax | 513-521-3477
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Provider Business Mailing Address
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Address Line | 7000 HOUSTON RD SUITE 29
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City | FLORENCE
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State | KY
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Zip | 41042-4879
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Country | US
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Telephone | 859-746-9272
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Fax | 859-746-9322
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ANNE M MANGOLD
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Credential | LCSW
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Telephone | 859-512-0334
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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 | 193400000X
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License Number State | KY
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