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General NPI Number Information
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NPI Number | 1538569835
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTHCARE PATHWAYS LLC
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Dates
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Enumeration Date | 08/25/2014
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Last Update Date | 06/10/2016
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Provider Practice Location Address
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Address Line | 34 JEROME AVE SUITE 218
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City | BLOOMFIELD
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State | CT
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Zip | 06002-2463
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Country | US
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Telephone | 860-519-3117
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Fax | 860-285-8287
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Provider Business Mailing Address
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Address Line | PO BOX 911
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City | WINDSOR
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State | CT
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Zip | 06095-0911
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Country | US
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Telephone | 860-519-3117
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Fax | 860-519-3117
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JEREMIAH KARANJA
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Credential | LPC
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Telephone | 860-519-3117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 002250
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License Number State | CT
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