MEDICARE: COURAGEOUS 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1942168927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COURAGEOUS PATHWAYS COUNSELING LLC

Provider Business Mailing Address
First Line	:	4604 HOBBS WAY
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40515-6295
Country	:	US
Telephone Number	:	859-379-8338
Fax Number	:

Provider Business Practice Location Address
First Line	:	4604 HOBBS WAY
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40515-6295
Country	:	US
Telephone Number	:	859-379-8338
Fax Number	:

Authorized Official
Title or Position	:	LPCA/MANAGER
Name	:	JASON L RAY
Credential	:	LPCA
Telephone Number	:	859-544-5574

Provider Enumeration Date	:	01/09/2026
Last Update Date	:	01/09/2026

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