MEDICARE: PATH 2 PURPOSE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1326937731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATH 2 PURPOSE LLC

Provider Business Mailing Address
First Line	:	3114 W NORTH AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21216-3012
Country	:	US
Telephone Number	:	443-286-9535
Fax Number	:

Provider Business Practice Location Address
First Line	:	3114 W NORTH AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21216-3012
Country	:	US
Telephone Number	:	443-286-9535
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. NICKIA WILLIAMS
Credential	:	BS
Telephone Number	:	443-286-9535

Provider Enumeration Date	:	07/01/2025
Last Update Date	:	03/02/2026

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Directions to “PATH 2 PURPOSE LLC ” Practice Location

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