Provider Demographics
NPI:1053104190
Name:HEALING PATHWAY THERAPY LLC
Entity type:Organization
Organization Name:HEALING PATHWAY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOURDYCE
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:563-296-5003
Mailing Address - Street 1:1500 PLAZA PL STE 108
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-5315
Mailing Address - Country:US
Mailing Address - Phone:563-296-5003
Mailing Address - Fax:563-296-5004
Practice Address - Street 1:1500 PLAZA PL STE 108
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-5315
Practice Address - Country:US
Practice Address - Phone:563-296-5003
Practice Address - Fax:563-296-5004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty