Provider Demographics
NPI:1730325432
Name:PATHWAYS OHIO COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:PATHWAYS OHIO COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:NELIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSSA, LISW-S
Authorized Official - Phone:330-921-8308
Mailing Address - Street 1:58 SOUTH MAIN ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-7479
Mailing Address - Country:US
Mailing Address - Phone:330-921-8308
Mailing Address - Fax:330-757-1166
Practice Address - Street 1:58 S MAIN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-1978
Practice Address - Country:US
Practice Address - Phone:330-921-8308
Practice Address - Fax:330-757-1166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-30
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI05000511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty