MEDICARE: GUIDING PATHS THERAPY SERVICES, 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	:	1922614452
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUIDING PATHS THERAPY SERVICES, LLC

Provider Business Mailing Address
First Line	:	526 CLINTON SPRINGS AVE # C
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45217-1955
Country	:	US
Telephone Number	:	513-349-5504
Fax Number	:

Provider Business Practice Location Address
First Line	:	526 CLINTON SPRINGS AVE # C
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45217-1955
Country	:	US
Telephone Number	:	513-349-5504
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	MRS. AUNGELIQUE R HEATER
Credential	:	MSW, LISW
Telephone Number	:	513-349-5504

Provider Enumeration Date	:	09/21/2020
Last Update Date	:	10/16/2020

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