| Pathways 2 Pllc | |
|
11662 Martin Rd Warren MI 48093-4588 | |
| (586) 558-6868 | |
| (586) 558-6893 |
| Full Name | Pathways 2 Pllc |
|---|---|
| Speciality | Counselor |
| Location | 11662 Martin Rd, Warren, Michigan |
| Authorized Official Name and Position | Debra Loving (OWNER) |
| Authorized Official Contact | 5865586868 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pathways 2 Pllc 11662 Martin Rd Warren MI 48093-4588 Ph: (586) 558-6868 | Pathways 2 Pllc 11662 Martin Rd Warren MI 48093-4588 Ph: (586) 558-6868 |
| NPI Number | 1417209057 |
|---|---|
| Provider Enumeration Date | 10/05/2012 |
| Last Update Date | 05/11/2024 |
| Certification Date | 05/11/2024 |
| Medicare PECOS PAC ID | 2062646979 |
|---|---|
| Medicare Enrollment ID | O20131009000243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417209057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 6401013130 (Michigan) | Primary |
| 101YM0800X | Counselor - Mental Health | 2102227 (Michigan) | Secondary |
| Provider Name | Daniel St Amour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164933354 PECOS PAC ID: 0345376083 Enrollment ID: I20180402001801 |
| Provider Name | Nicole Hentschel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306373873 PECOS PAC ID: 5799040903 Enrollment ID: I20180517000744 |
| Provider Name | Alison Fuller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265095384 PECOS PAC ID: 4880022664 Enrollment ID: I20200309001829 |
| Provider Name | Adriel A Lechner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295349322 PECOS PAC ID: 8729491121 Enrollment ID: I20210104000232 |
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