| Star Pathways | |
|
70 Birch Aly Ste 240 Beavercreek OH 45440-1477 | |
| (866) 975-7469 | |
| Not Available |
| Full Name | Star Pathways |
|---|---|
| Speciality | Clinic/Center |
| Location | 70 Birch Aly Ste 240, Beavercreek, Ohio |
| Authorized Official Name and Position | Yvette Dorsey-benson (CEO) |
| Authorized Official Contact | 8669757469 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Star Pathways 70 Birch Aly Ste 240 Beavercreek OH 45440-1477 Ph: () - | Star Pathways 70 Birch Aly Ste 240 Beavercreek OH 45440-1477 Ph: (866) 975-7469 |
| NPI Number | 1073016440 |
|---|---|
| Provider Enumeration Date | 03/13/2018 |
| Last Update Date | 09/29/2022 |
| Certification Date | 09/29/2022 |
| Medicare PECOS PAC ID | 8325434558 |
|---|---|
| Medicare Enrollment ID | O20220414002552 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073016440 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Yvette Dorsey-benson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083928386 PECOS PAC ID: 9234525460 Enrollment ID: I20220414002557 |
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