Organization Active NPI

Pathways Unlimited, Inc

  • Psychologist
  • Stone Mountain, GA
National Provider Identifier
1871764282
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2373 Issued in GA
Legal business name
PATHWAYS UNLIMITED, INC
Practice address
913 Main St Ste H
Stone Mountain, GA 30083-3096
Phone
(770) 413-1980
Fax
(770) 413-8118
NPI assigned
Mar 13, 2008
Last updated
Mar 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Authorized official

Name
Dr. Monique Farr Gray, PH.D.NPI 1891865317
Title
Psychologist
Phone
(770) 413-1980

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2373 GA Primary

Addresses

Primary practice location

913 Main St Ste H
Stone Mountain, GA 30083-3096

Mailing address

913 Main St Ste H
Stone Mountain, GA 30083-3096
Phone (770) 413-1980

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120925000264 GA Part B Supplier - Clinic/Group Practice 7416106000 Receives reassigned benefits from 1 practitioner
Practice locations: Stone Mountain, GA

National Provider Directory

National Provider Directory

Locations

331 Arcado Rd NW
Ste B
Lilburn, GA 30047
Phone (678) 205-0877

913 Main St
Ste H
Stone Mountain, GA 30083
Phone (770) 413-1980

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205366400000",
    "number": "1871764282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 MAIN ST STE H",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833096",
            "telephone_number": "770-413-1980",
            "fax_number": "770-413-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 MAIN ST STE H",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833096",
            "telephone_number": "770-413-1980",
            "fax_number": "770-413-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAYS UNLIMITED, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-03-13",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "MONIQUE",
        "authorized_official_middle_name": "FARR",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "770-413-1980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "2373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; 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.