| Pathway To Eden | |
|
107 Brookside Way Pikeville NC 27863-8480 | |
| (919) 980-0824 | |
| Not Available |
| Full Name | Pathway To Eden |
|---|---|
| Speciality | Social Worker |
| Location | 107 Brookside Way, Pikeville, North Carolina |
| Authorized Official Name and Position | Donita Smith (OWNER) |
| Authorized Official Contact | 9199800824 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pathway To Eden 2342 Forest Hills Rd W # 1067 Wilson NC 27893-3416 Ph: (919) 980-0824 | Pathway To Eden 107 Brookside Way Pikeville NC 27863-8480 Ph: (919) 980-0824 |
| NPI Number | 1073340592 |
|---|---|
| Provider Enumeration Date | 09/18/2024 |
| Last Update Date | 09/18/2024 |
| Certification Date | 09/18/2024 |
| Medicare PECOS PAC ID | 9537695580 |
|---|---|
| Medicare Enrollment ID | O20241213001022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073340592 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Donita L Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033758693 PECOS PAC ID: 8224479498 Enrollment ID: I20240520000093 |
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