Pathway Psychological Services PLLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

PATHWAY PSYCHOLOGICAL SERVICES PLLC

Practice address

22750 Woodward Ave Ste 211
Ferndale, MI 48220-1753

Phone

(810) 333-1386

NPI assigned

Jun 25, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Brian D Wummel, PH.D., LPC

Title

Owner and Counselor

Phone

(810) 333-1386

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Brian D. Wummel Doing business as

Locations

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561420800000",
    "number": "1629639190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1683 RIVERSIDE DR APT 2",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483092708",
            "telephone_number": "810-333-1386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22750 WOODWARD AVE STE 211",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201753",
            "telephone_number": "810-333-1386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAY PSYCHOLOGICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-25",
        "last_updated": "2019-06-25",
        "status": "A",
        "authorized_official_last_name": "WUMMEL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER AND COUNSELOR",
        "authorized_official_telephone_number": "810-333-1386",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1811291818",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Brian D. Wummel",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Mental Health Clinic/Center in Ferndale, MI
• Providers in Ferndale, MI by specialty
• Adult Mental Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; 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.