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General NPI Number Information
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NPI Number | 1588905657
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Entity Type | Organization
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Legal Business Name | PATHWAYS TO EMPOWERMENT, LLC
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Dates
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Enumeration Date | 03/13/2013
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Last Update Date | 03/13/2013
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Provider Practice Location Address
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Address Line | 99 MAIN ST SUITE 1
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City | EAST WINDSOR
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State | CT
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Zip | 06088-1602
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Country | US
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Telephone | 860-670-4997
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Fax |
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Provider Business Mailing Address
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Address Line | 35 WOOLAM RD
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City | EAST WINDSOR
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State | CT
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Zip | 06088-9723
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Country | US
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Telephone | 860-995-5827
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Fax |
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Authorized Official
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Title or Position | CLINICAL SW
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Name | JOANN L BURNHAM
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Credential | LCSW
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Telephone | 860-995-5827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 008188
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License Number State | CT
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