Pathway Healthcare LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

PATHWAY HEALTHCARE LLC

Practice address

16 Coolidge Place
Hackensack, NJ 07601

Phone

(732) 731-9617

NPI assigned

Oct 29, 2024

Organization subpart

No

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

Authorized official

Name

Olufunke Adebanjo

Title

Owner

Phone

(469) 530-4932

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

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

• Alexis Dominguez, MA, LMHC

  • Professional Counselor
  • Hackensack, NJ
  • NPI 1487171567

  Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1730160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1487476644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 COOLIDGE PLACE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 COOLIDGE PLACE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601",
            "telephone_number": "732-731-9617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAY HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-29",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "ADEBANJO",
        "authorized_official_first_name": "OLUFUNKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-530-4932"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.