| Phoenix Pathways LLC. | |
|
175 Langley Drive Building E, Suite 1 Lawrenceville GA 30046 | |
| (470) 715-3588 | |
| Not Available |
| Full Name | Phoenix Pathways LLC. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 175 Langley Drive, Lawrenceville, Georgia |
| Authorized Official Name and Position | Jonita Mckinney (CEO) |
| Authorized Official Contact | 4707153588 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Pathways LLC. 175 Langley Drive Building E, Suite 1 Lawrenceville GA 30046 Ph: (470) 715-3588 | Phoenix Pathways LLC. 175 Langley Drive Building E, Suite 1 Lawrenceville GA 30046 Ph: (470) 715-3588 |
| NPI Number | 1174355333 |
|---|---|
| Provider Enumeration Date | 08/16/2024 |
| Last Update Date | 08/16/2024 |
| Certification Date | 08/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174355333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Secondary |
| 1041C0700X | Social Worker - Clinical | () | Primary |
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