Organization
PATHWAY HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA RADCLIFFE DNP, FNP, PMHNP (FOUNDER)
(801) 792-5557
Entity
Organization
Contact information
Practice address
150 S 600 E STE 3A, SALT LAKE CITY, UT 84102-1961
(801) 792-5557
Mailing address
150 S 600 E STE 3A, SALT LAKE CITY, UT 84102-1961
(801) 792-5557
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106S00000X
Behavior Technician
—
—
132700000X
Dietary Manager
—
—
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
—
—
171M00000X
Case Manager/Care Coordinator
—
—
225A00000X
Music Therapist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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