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General NPI Number Information
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NPI Number | 1922025964
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Entity Type | Organization
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Legal Business Name | CREATIVE PATHWAYS COUNSELING LLC
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 12/06/2011
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Provider Practice Location Address
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Address Line | 6 BROADWAY
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City | BANGOR
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State | PA
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Zip | 18013-2602
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Country | US
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Telephone | 610-588-0744
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Fax | 610-588-8944
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Provider Business Mailing Address
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Address Line | 6 BROADWAY
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City | BANGOR
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State | PA
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Zip | 18013-2602
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Country | US
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Telephone | 610-588-0744
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Fax | 610-588-8944
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MR. ANDREW M RACHLIN
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Credential |
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Telephone | 610-588-0744
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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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