Organization
PATHWAYS TO CHANGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY HEENAN PHD, LPC, LMFT (CO-OWNER)
(307) 265-4000
Entity
Organization
Contact information
Practice address
3211 ENERGY LN, SUITE 206, CASPER, WY 82604-2941
(307) 265-4000
(307) 265-4000
Mailing address
3211 ENERGY LN, SUITE 206, CASPER, WY 82604-2941
(307) 265-4000
(307) 265-4000
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
LMFT 139
WY
251S00000X
Community/Behavioral Health Agency
Primary
LPC 1059
WY
251S00000X
Community/Behavioral Health Agency
LPC 1073
WY
Other
Enumeration date
03/27/2011
Last updated
10/21/2011
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