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NPI Code Detail

MEDICARE: PATHWAYS...A COUNSELING AND LEARNING CENTER, INC.

MEDICARE: PATHWAYS...A COUNSELING AND LEARNING CENTER, INC.
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
11041C0700XClinical Social Worker117375-3501UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598874133
Entity Type Code : Organization
Provider Name (Legal Business Name) : PATHWAYS...A COUNSELING AND LEARNING CENTER, INC.
Provider Business Mailing Address
First Line : PO BOX 9128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84109-0128
Country : US
Telephone Number : 801-485-2674
Fax Number : 801-485-2674
Provider Business Practice Location Address
First Line : 1104 ASHTON AVE
Second Line : 114
City : SALT LAKE CITY
State : UT
Zip : 84106-4504
Country : US
Telephone Number : 801-558-8650
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. MICHAEL C FLOWERS
Credential : LCSW
Telephone Number : 801-558-8650
Provider Enumeration Date : 08/29/2006
Last Update Date : 06/25/2008

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Directions to “PATHWAYS...A COUNSELING AND LEARNING CENTER, INC. ” Practice Location

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