Provider Demographics
NPI:1861238644
Name:OPTIMISTIC PATHWAYS COUNSELING & CONSULTING LLC
Entity type:Organization
Organization Name:OPTIMISTIC PATHWAYS COUNSELING & CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LISW-CP
Authorized Official - Phone:843-230-2889
Mailing Address - Street 1:PO BOX 1637
Mailing Address - Street 2:
Mailing Address - City:KENAI
Mailing Address - State:AK
Mailing Address - Zip Code:99611-1637
Mailing Address - Country:US
Mailing Address - Phone:843-230-2889
Mailing Address - Fax:
Practice Address - Street 1:1900 BARNWELL DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-1464
Practice Address - Country:US
Practice Address - Phone:301-202-4305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health