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General NPI Number Information
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NPI Number | 1679390819
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Entity Type | Organization
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Legal Business Name | MINDFUL PATHWAY THERAPY AND COUNSELING LLC
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Dates
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Enumeration Date | 09/19/2024
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 595 E MAIN ST
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City | PRICE
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State | UT
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Zip | 84501
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Country | US
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Telephone | 435-200-4784
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Fax | 844-893-5798
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Provider Business Mailing Address
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Address Line | 595 E MAIN ST
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City | PRICE
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State | UT
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Zip | 84501
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Country | US
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Telephone | 435-200-4784
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Fax | 844-893-5798
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Authorized Official
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Title or Position | MEMBER
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Name | JESSICA TRIPP
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Credential |
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Telephone | 385-402-9015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #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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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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