NPIMap

Organization Active NPI

Pathways Psychological Services, P.a.

  • Mental Health Counselor
  • Plymouth, MN
National Provider Identifier
1366443723
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
PATHWAYS PSYCHOLOGICAL SERVICES, P.A.
Practice address
10700 Old County Road 15 Ste 170
Plymouth, MN 55441-8709
Phone
(763) 525-8590
Fax
(763) 525-8592
NPI assigned
Aug 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

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

Authorized official

Name
Savanah Wimbush
Title
Office Manager
Phone
(763) 525-8590

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X MN Primary

Addresses

Primary practice location

10700 Old County Road 15 Ste 170
Plymouth, MN 55441-8709

Mailing address

10700 Old County Road 15 Ste 170
Plymouth, MN 55441-8709
Phone (763) 525-8590

Other identifiers 4

IdentifierTypeStateIssuer
776781100MedicaidMN
108992OtherMNUCARE
35674OtherMNHEALTHPARTNERS
8H914PAOtherMNBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050525000597 MN Part B Supplier - Clinic/Group Practice 9133161672 Receives reassigned benefits from 7 practitioners
Practice locations: Plymouth, MN

National Provider Directory

National Provider Directory

Locations

19230 Evans St NW
Ste 202A
Elk River, MN 55330
Phone (763) 241-8157

7575 Golden Valley Rd
Ste 230
Minneapolis, MN 55427
Phone (763) 525-8590

10700 Old County Road 15
Ste 170
Plymouth, MN 55441
Phone (763) 525-8590

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767139200000",
    "number": "1366443723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 OLD COUNTY ROAD 15 STE 170",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554418709",
            "telephone_number": "763-525-8590",
            "fax_number": "763-525-8592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 OLD COUNTY ROAD 15 STE 170",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554418709",
            "telephone_number": "763-525-8590",
            "fax_number": "763-525-8592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAYS PSYCHOLOGICAL SERVICES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A",
        "authorized_official_last_name": "WIMBUSH",
        "authorized_official_first_name": "SAVANAH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "763-525-8590"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "776781100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "108992",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "35674",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8H914PA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; 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.