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General NPI Number Information
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NPI Number | 1598059859
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Entity Type | Organization
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Legal Business Name | EMERGING PATHWAYS, LLC
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Dates
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Enumeration Date | 06/04/2011
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Last Update Date | 06/04/2011
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Provider Practice Location Address
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Address Line | 5110 S FLORIDA AVE SUITE 105
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City | LAKELAND
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State | FL
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Zip | 33813-2512
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Country | US
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Telephone | 863-640-2807
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Fax | 863-510-5903
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Provider Business Mailing Address
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Address Line | 5110 S FLORIDA AVE SUITE 105
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City | LAKELAND
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State | FL
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Zip | 33813-2512
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Country | US
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Telephone | 863-640-2807
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Fax | 863-510-5903
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARY ELISABETH BEIKIRCH-GODWIN
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Credential | MA, LMHC, CAP
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Telephone | 863-640-2807
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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 | MH8009
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | MH8009
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CAP4269
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | MH8009
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License Number State | FL
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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 | 651278
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH8009
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License Number State | FL
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