MEDICARE: PATHWAYS4SUCCESS 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	103K00000X	Behavior Analyst
2	261QD1600X	Developmental Disabilities Clinic/Center

General Provider Information

NPI Number	:	1952235335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATHWAYS4SUCCESS LLC

Provider Business Mailing Address
First Line	:	2212 SULLENBERGER WAY
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-4646
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2212 SULLENBERGER WAY
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-4646
Country	:	US
Telephone Number	:	440-732-8686
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	MS. PRAGYA JHA
Credential	:	BCBA, COBA, LBA
Telephone Number	:	440-732-8686

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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Directions to “PATHWAYS4SUCCESS LLC ” Practice Location

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