MEDICARE: SUPPORTIVE PATHWAYS COUNSELING, LLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1497619811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPPORTIVE PATHWAYS COUNSELING, LLC

Provider Business Mailing Address
First Line	:	86 CHESTNUT GROVE RD
Second Line	:
City	:	CONESTOGA
State	:	PA
Zip	:	17516-9316
Country	:	US
Telephone Number	:	717-584-4406
Fax Number	:

Provider Business Practice Location Address
First Line	:	86 CHESTNUT GROVE RD
Second Line	:
City	:	CONESTOGA
State	:	PA
Zip	:	17516-9316
Country	:	US
Telephone Number	:	717-584-4406
Fax Number	:

Authorized Official
Title or Position	:	LCSW, OUTPATIENT THERAPIST
Name	:	LAURA HANK
Credential	:	LCSW
Telephone Number	:	717-584-4406

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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