| Pathways Therapy Pllc | |
|
1750 E Grand River Ave Ste 101 East Lansing MI 48823-4958 | |
| (517) 930-6123 | |
| Not Available |
| Full Name | Pathways Therapy Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1750 E Grand River Ave Ste 101, East Lansing, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769788 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pathways Therapy Pllc Po Box 10 Mason MI 48854-0010 Ph: () - | Pathways Therapy Pllc 1750 E Grand River Ave Ste 101 East Lansing MI 48823-4958 Ph: (517) 930-6123 |
| NPI Number | 1134647993 |
|---|---|
| Provider Enumeration Date | 08/31/2017 |
| Last Update Date | 02/02/2022 |
| Certification Date | 02/02/2022 |
| Medicare PECOS PAC ID | 0446524086 |
|---|---|
| Medicare Enrollment ID | O20170921000838 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134647993 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | 6801097237 (Michigan) | Secondary |
| Provider Name | Ashley Gulker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306243332 PECOS PAC ID: 7315211851 Enrollment ID: I20170921001182 |
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