| Pathways To Healing Therapy Services | |
|
3001 Montvale Dr Ste F Springfield IL 62704-5361 | |
| (217) 836-6101 | |
| Not Available |
| Full Name | Pathways To Healing Therapy Services |
|---|---|
| Speciality | Social Worker |
| Location | 3001 Montvale Dr Ste F, Springfield, Illinois |
| Authorized Official Name and Position | Emily S Lane (OWNER) |
| Authorized Official Contact | 2178366101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pathways To Healing Therapy Services 1605 S Douglas Ave Springfield IL 62704-3517 Ph: (217) 836-6101 | Pathways To Healing Therapy Services 3001 Montvale Dr Ste F Springfield IL 62704-5361 Ph: (217) 836-6101 |
| NPI Number | 1417681149 |
|---|---|
| Provider Enumeration Date | 07/09/2022 |
| Last Update Date | 08/06/2023 |
| Certification Date | 08/06/2023 |
| Medicare PECOS PAC ID | 5799161774 |
|---|---|
| Medicare Enrollment ID | O20220928001294 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417681149 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Emily Sue Lane |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083962583 PECOS PAC ID: 9931359106 Enrollment ID: I20121024000393 |
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