Peaceful Path Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I05569 Issued in NM

Legal business name

PEACEFUL PATH COUNSELING LLC

Practice address

1199 Main Ave Ste 214
Durango, CO 81301-4158

Phone

(970) 946-0992

Fax

(239) 558-5775

NPI assigned

Aug 29, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Margery H Runyan, PHD LISW CADAC

Title

Owner

Phone

(970) 946-0992

Specialties & licenses 4

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453161600000",
    "number": "1467701037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1199 MAIN AVE STE 214",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813014158",
            "telephone_number": "970-946-0992",
            "fax_number": "239-558-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 MAIN AVE STE 214",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813014158",
            "telephone_number": "970-946-0992",
            "fax_number": "239-558-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEFUL PATH COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-29",
        "last_updated": "2016-01-19",
        "status": "A",
        "authorized_official_last_name": "RUNYAN",
        "authorized_official_first_name": "MARGERY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-946-0992",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD LISW CADAC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "1042",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "6697",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I05569",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "9630022",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64856232",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31882021",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Durango, CO
• Providers in Durango, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; 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.