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General NPI Number Information
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NPI Number | 1417773193
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Entity Type | Organization
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Legal Business Name | PATHWAYS INC
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Dates
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Enumeration Date | 11/27/2024
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 2670 CRAIN HWY STE 300
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City | WALDORF
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State | MD
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Zip | 20601-2817
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Country | US
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Telephone | 301-373-3065
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Fax | 240-309-4131
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Provider Business Mailing Address
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Address Line | PO BOX 129
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City | HOLLYWOOD
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State | MD
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Zip | 20636-0129
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Country | US
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Telephone | 13-733-0653
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Fax | 240-309-4131
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BIRGIT J LOCKLEAR
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Credential | LCSW-C
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Telephone | 301-538-3753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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