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General NPI Number Information
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NPI Number | 1538640156
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Entity Type | Organization
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Legal Business Name | CREATIVE PATHWAYS INTEGRATED HEALTHCARE, LLC
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Dates
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Enumeration Date | 08/22/2018
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Last Update Date | 08/22/2018
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Provider Practice Location Address
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Address Line | 103 S BRADY ST
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City | RAMSEUR
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State | NC
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Zip | 27316-9538
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Country | US
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Telephone | 240-278-0069
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Fax | 888-321-3812
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Provider Business Mailing Address
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Address Line | 103 S BRADY ST
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City | RAMSEUR
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State | NC
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Zip | 27316-9538
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Country | US
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Telephone | 240-278-0069
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Fax | 888-321-3812
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Authorized Official
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Title or Position | CEO
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Name | MONICA WILLIAMS
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Credential |
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Telephone | 240-278-0069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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Taxonomy #2
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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 #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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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 | 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 #5
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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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Taxonomy #6
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #8
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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 | NC
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