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General NPI Number Information
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NPI Number | 1437581683
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Entity Type | Organization
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Legal Business Name | NEW PATHWAYS LLC
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Dates
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Enumeration Date | 07/30/2013
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Last Update Date | 07/30/2013
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Provider Practice Location Address
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Address Line | 223 N 3RD #206
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City | MUSKOGEE
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State | OK
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Zip | 74401-6609
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Country | US
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Telephone | 918-682-7797
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Fax | 918-686-8881
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Provider Business Mailing Address
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Address Line | 223 N 3RD ST STE 206
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City | MUSKOGEE
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State | OK
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Zip | 74401-6686
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Country | US
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Telephone | 918-682-7797
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Fax | 918-686-8881
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MS. MARY CARROL WARD
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Credential | LPC
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Telephone | 918-682-7797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 4131
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License Number State | OK
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