Pathway Practice, Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C0007674 Issued in OH

Legal business name

PATHWAY PRACTICE, INC.

Practice address

201 Hospital Dr
Dover, OH 44622-2058

Phone

(330) 343-6631

Fax

(330) 343-8188

NPI assigned

Feb 27, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Joseph J Gavin, PH.D.

Title

Ceo

Phone

(330) 343-6631

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235692800000",
    "number": "1073753257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446220007",
            "telephone_number": "330-343-6631",
            "fax_number": "330-343-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 HOSPITAL DR",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222058",
            "telephone_number": "330-343-6631",
            "fax_number": "330-343-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAY PRACTICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-27",
        "last_updated": "2009-02-27",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-343-6631",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E0001959SUPV",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C0007674",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "OH",
            "license": "1957",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S0017766",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.