DBA PACIFIC PATHWAYS – NPI #1649882606
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Mental Illness

DBA PACIFIC PATHWAYS is a community based residential treatment facility located in PETALUMA, CA. NPPES has assigned the NPI number 1649882606 to DBA PACIFIC PATHWAYS on August 20, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “DBA PACIFIC PATHWAYS” is a dba name, the actual legal business name for this organization is BROOKE BRODY LICENSED CLINICAL SOCIAL WORKER, PC. The primary taxonomy selected by this provider is 320800000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Mental Illness.

The NPI profile was previously updated about 5 years ago on Jun 01, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for DBA PACIFIC PATHWAYS below.

NPI Profile for
BROOKE BRODY LICENSED CLINICAL SOCIAL WORKER, PC

NPI Number
1649882606
Enumeration Date

(about 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BROOKE BRODY LICENSED CLINICAL SOCIAL WORKER, PC
Doing Business As (dba): DBA PACIFIC PATHWAYS
Primary location
621A 2ND ST
PETALUMA, CA 94952
Phone: (707) 708-3090 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
BROOKE BRODY
OWNER
Phone: (240) 994-4926
Updated
Certification Date
Jun 01, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320800000X
- Community Based Residential Treatment Facility, Mental Illness (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.