Provider Demographics
NPI:1881064756
Name:PATHWAYS TO HEALING COUNSELING, LLC
Entity type:Organization
Organization Name:PATHWAYS TO HEALING COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:BOICE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:317-316-3077
Mailing Address - Street 1:1212 WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-9278
Mailing Address - Country:US
Mailing Address - Phone:317-316-3077
Mailing Address - Fax:
Practice Address - Street 1:107 CHEROKEE LN
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-9073
Practice Address - Country:US
Practice Address - Phone:317-316-3077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-04
Last Update Date:2015-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001794A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN35001794AOtherSTATE OF INDIANA MARRIAGE AND FAMILY THERAPIST LICENSE NUMBER