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General NPI Number Information
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NPI Number | 1568269678
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Entity Type | Organization
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Legal Business Name | THE HEART STONE PATHWAY L.L.C
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 905 N 7TH ST
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City | MONTROSE
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State | CO
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Zip | 81401-3252
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Country | US
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Telephone | 970-814-4640
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Fax |
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Provider Business Mailing Address
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Address Line | 905 N 7TH ST
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City | MONTROSE
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State | CO
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Zip | 81401-3252
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Country | US
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Telephone | 970-814-4640
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | BRENDA LEE HUBBARD
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Credential | LCSW, MSW, LAC, ADS
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Telephone | 970-814-4640
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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 |
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License Number State |
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Taxonomy #2
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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 |
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