Pathways Llc | |
1301b Harrison Ave Mccomb MS 39648-2829 | |
(601) 600-2429 | |
(601) 600-2428 |
Full Name | Pathways Llc |
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Speciality | Social Worker |
Location | 1301b Harrison Ave, Mccomb, Mississippi |
Authorized Official Name and Position | Bente Hess Johnson (SOLE MEMBER) |
Authorized Official Contact | 6016002429 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Pathways Llc 2184 Old Liberty Rd Mccomb MS 39648-9123 Ph: (601) 600-2429 | Pathways Llc 1301b Harrison Ave Mccomb MS 39648-2829 Ph: (601) 600-2429 |
NPI Number | 1104287937 |
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Provider Enumeration Date | 03/07/2016 |
Last Update Date | 03/07/2016 |
Medicare PECOS PAC ID | 9133401797 |
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Medicare Enrollment ID | O20170117001205 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104287937 | NPI | - | NPPES |
Provider Name | Bente Johnson |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1023479854 PECOS PAC ID: 0042592602 Enrollment ID: I20170117001520 |
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