Provider Demographics
NPI:1366244691
Name:PATHWAYS UPSTREAM, PLLC
Entity type:Organization
Organization Name:PATHWAYS UPSTREAM, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CACKLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, MPH
Authorized Official - Phone:801-228-0927
Mailing Address - Street 1:7533 S CENTER VIEW CT STE N
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-5526
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1399 S 700 E STE 17
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-2171
Practice Address - Country:US
Practice Address - Phone:801-228-0927
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-26
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health