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General NPI Number Information
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NPI Number | 1427732999
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Entity Type | Organization
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Legal Business Name | UPWARD PATH, LLC
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Dates
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Enumeration Date | 06/14/2023
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 3280 SOUTH COUNTRY CLUB WAY BUILDING B, SUITE 112
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City | TEMPE
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State | AZ
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Zip | 85282
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Country | US
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Telephone | 480-689-3525
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Fax |
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Provider Business Mailing Address
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Address Line | 3280 SOUTH COUNTRY CLUB WAY BUILDING B, SUITE 112
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City | TEMPE
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State | AZ
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Zip | 85282
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. ROBERT MICHAEL MCCAULEY II
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Credential |
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Telephone | 806-239-4624
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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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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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