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General NPI Number Information
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NPI Number | 1942490438
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Entity Type | Organization
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Legal Business Name | PATHWAYS COUNSELING CENTER II LLC
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Dates
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Enumeration Date | 07/31/2007
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 11121 W OKLAHOMA AVE
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City | WEST ALLIS
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State | WI
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Zip | 53227-4033
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Country | US
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Telephone | 262-641-9790
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Fax | 262-641-9791
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Provider Business Mailing Address
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Address Line | 11121 W OKLAHOMA AVE
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City | WEST ALLIS
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State | WI
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Zip | 53227-4033
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Country | US
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Telephone | 262-641-9790
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Fax | 262-641-9791
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | RYAN STAHL-SUSSEK
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Credential |
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Telephone | 262-754-5921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1730
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 1730
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 1730
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License Number State | WI
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Taxonomy #4
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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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