MEDICARE: PATHWAYS TRANSITION PROGRAMS, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YP2500X	Professional Counselor
2	103T00000X	Psychologist
3	104100000X	Social Worker

General Provider Information

NPI Number	:	1508913963
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATHWAYS TRANSITION PROGRAMS, INC

Provider Business Mailing Address
First Line	:	120 E TRINITY PL
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-3302
Country	:	US
Telephone Number	:	404-378-2300
Fax Number	:	404-378-2394

Provider Business Practice Location Address
First Line	:	120 E TRINITY PL
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-3302
Country	:	US
Telephone Number	:	404-378-2300
Fax Number	:	404-378-2394

Authorized Official
Title or Position	:	CEO & CLINICAL DIRECTOR
Name	:	DR. SUNAINA RAO JAIN
Credential	:	PH.D.
Telephone Number	:	404-378-2300

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	08/08/2007

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