| Pathways To Growth Psychotherapy Llc | |
|
5601 Terrace Dr Johnston IA 50131-1571 | |
| (515) 979-8502 | |
| Not Available |
| Full Name | Pathways To Growth Psychotherapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 5601 Terrace Dr, Johnston, Iowa |
| Authorized Official Name and Position | Angela L Emerson (OWNER OF ENTITY) |
| Authorized Official Contact | 5159798502 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pathways To Growth Psychotherapy Llc 5601 Terrace Dr Johnston IA 50131-1571 Ph: (515) 979-8502 | Pathways To Growth Psychotherapy Llc 5601 Terrace Dr Johnston IA 50131-1571 Ph: (515) 979-8502 |
| NPI Number | 1437742731 |
|---|---|
| Provider Enumeration Date | 02/17/2021 |
| Last Update Date | 02/17/2021 |
| Certification Date | 02/17/2021 |
| Medicare PECOS PAC ID | 6709285422 |
|---|---|
| Medicare Enrollment ID | O20210601001067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437742731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Angela L Emerson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942684725 PECOS PAC ID: 0749544369 Enrollment ID: I20180508001377 |
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