=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639026099
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PATHWAYS TO RENEWAL, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/13/2026
-----------------------------------------------------
Last Update Date | 03/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 115 LAKE DR
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19956-1707
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-396-9114
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 115 LAKE DR
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19956-1707
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-396-9114
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOLE MEMBER
-----------------------------------------------------
Name | MRS. ERICA J PERSAUD
-----------------------------------------------------
Credential | LPCMH, LCDC
-----------------------------------------------------
Telephone | 302-396-9114
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------