NPIMap

Organization Active NPI

Pathways Professional Counseling LLC

  • Community/Behavioral Health Agency
  • Oklahoma City, OK
National Provider Identifier
1043392558
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PATHWAYS PROFESSIONAL COUNSELING LLC
Practice address
13707 Fairhill Ave
Oklahoma City, OK 73013
Phone
(405) 607-4041
Fax
(405) 463-0090
NPI assigned
Oct 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Zachory Edward Randall, LPCNPI 1386960912
Title
Ceo/President
Phone
(405) 607-4041

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

13707 Fairhill Ave
Oklahoma City, OK 73013

Mailing address

13707 Fairhill Ave
Oklahoma City, OK 73013
Phone (405) 607-4041

Other identifiers 1

IdentifierTypeStateIssuer
200007660 AMedicaidOK

Other names 1

  • Pathways Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110118000834 OK Part B Supplier - Clinic/Group Practice 1254520596 Practice locations: Edmond, OK

National Provider Directory

National Provider Directory

Locations

1017 NW 6th St
Oklahoma City, OK 73106
Phone (405) 605-8282

Practitioners & affiliated clinicians

Practitioners 74

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 74

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1043392558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13707 FAIRHILL AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73013",
            "telephone_number": "405-607-4041",
            "fax_number": "405-463-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13707 FAIRHILL AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73013",
            "telephone_number": "405-607-4041",
            "fax_number": "405-463-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAYS PROFESSIONAL COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "ZACHORY",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "405-607-4041",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200007660 A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pathways",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Pathways",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.