MEDICARE: PATHWAYS BEHAVIORAL HEALTH

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1376852764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATHWAYS BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	4160 S PECOS RD STE 17
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5027
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4160 S PECOS RD STE 17
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5027
Country	:	US
Telephone Number	:	702-332-8777
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MELISSA MORGAN
Credential	:
Telephone Number	:	702-332-8777

Provider Enumeration Date	:	10/01/2010
Last Update Date	:	10/01/2010

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Directions to “PATHWAYS BEHAVIORAL HEALTH ” Practice Location

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