Provider Demographics
NPI:1861186488
Name:THE PATH FORWARD SUPPORT SERVICES
Entity type:Organization
Organization Name:THE PATH FORWARD SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCKWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-S
Authorized Official - Phone:682-232-3499
Mailing Address - Street 1:3611 W PIONEER PKWY STE H
Mailing Address - Street 2:
Mailing Address - City:PANTEGO
Mailing Address - State:TX
Mailing Address - Zip Code:76013-4516
Mailing Address - Country:US
Mailing Address - Phone:682-232-3499
Mailing Address - Fax:
Practice Address - Street 1:3611 W PIONEER PKWY STE H
Practice Address - Street 2:
Practice Address - City:PANTEGO
Practice Address - State:TX
Practice Address - Zip Code:76013-4516
Practice Address - Country:US
Practice Address - Phone:682-232-3499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty