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General NPI Number Information
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NPI Number | 1972003077
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Entity Type | Organization
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Legal Business Name | PATHWAYS PSYCHOTHERAPY, PLLC
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Dates
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Enumeration Date | 02/15/2018
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Last Update Date | 02/15/2018
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Provider Practice Location Address
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Address Line | 9313 FOXBURROW CT
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City | RALEIGH
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State | NC
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Zip | 27613-7505
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Country | US
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Telephone | 919-219-6256
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Fax | 919-845-4805
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Provider Business Mailing Address
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Address Line | 9313 FOXBURROW CT
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City | RALEIGH
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State | NC
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Zip | 27613-7505
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Country | US
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Telephone | 919-219-6256
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Fax | 919-845-4805
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE DAWN PHILLIPS
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Credential | MED., LPC, NCC, CCTP
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Telephone | 919-219-6256
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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 | NC
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