=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699584797
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PATHWAYS THERAPY CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/03/2025
-----------------------------------------------------
Last Update Date | 07/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5104 CENTRAL AVENUE PIKE
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37912-3517
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-243-4185
-----------------------------------------------------
Fax | 877-540-0353
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5104 CENTRAL AVENUE PIKE
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37912-3517
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-243-4185
-----------------------------------------------------
Fax | 877-540-0353
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/LICENSED PROFESSIONAL COUNSEL
-----------------------------------------------------
Name | SONDRA HALEY
-----------------------------------------------------
Credential | LPC-MHSP
-----------------------------------------------------
Telephone | 865-243-4185
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------