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General NPI Number Information
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NPI Number | 1487956710
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Entity Type | Organization
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Legal Business Name | PATHWAYS TO LIFE, INC
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Dates
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Enumeration Date | 11/18/2010
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Last Update Date | 08/21/2020
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Provider Practice Location Address
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Address Line | 1015 CONFERENCE DR
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City | GREENVILLE
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State | NC
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Zip | 27858-5969
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Country | US
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Telephone | 252-695-0269
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Fax |
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Provider Business Mailing Address
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Address Line | 150 E ARLINGTON BLVD STE E
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City | GREENVILLE
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State | NC
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Zip | 27858-5019
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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 | CEO
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Name | ONTARIO L CHAPPELL
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Credential | MS MFT
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Telephone | 252-347-6455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | NC
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Taxonomy #4
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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 | NC
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Taxonomy #5
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | NC
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Taxonomy #7
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State | NC
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Taxonomy #8
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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 | NC
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Taxonomy #9
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | NC
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