| Pathway Psychiatry And Counseling Center, Pllc | |
|
404 S Jackson Ave Suite 102 Wylie TX 75098 | |
| (214) 997-4459 | |
| (972) 848-8592 |
| Full Name | Pathway Psychiatry And Counseling Center, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 404 S Jackson Ave Suite 102, Wylie, Texas |
| Authorized Official Name and Position | Ashley Gardner (OWNER) |
| Authorized Official Contact | 2149974459 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pathway Psychiatry And Counseling Center, Pllc 211 Masters Ave Ste 102 Wylie TX 75098-3638 Ph: (214) 997-4459 | Pathway Psychiatry And Counseling Center, Pllc 404 S Jackson Ave Suite 102 Wylie TX 75098 Ph: (214) 997-4459 |
| NPI Number | 1194363804 |
|---|---|
| Provider Enumeration Date | 12/12/2019 |
| Last Update Date | 01/23/2024 |
| Certification Date | 01/23/2024 |
| Medicare PECOS PAC ID | 7517319940 |
|---|---|
| Medicare Enrollment ID | O20240122000650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194363804 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Ashley Gardner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619364569 PECOS PAC ID: 8426400854 Enrollment ID: I20240122000755 |
| Provider Name | Christopher Mathew Barela |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1922736610 PECOS PAC ID: 3274977434 Enrollment ID: I20240215004416 |
| Provider Name | Lauren Butcher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619653755 PECOS PAC ID: 6406290592 Enrollment ID: I20240216001327 |
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