Provider Demographics
NPI:1043717986
Name:NEW PATH PSYCHOTHERAPY
Entity Type:Organization
Organization Name:NEW PATH PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SINEAD
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-629-7080
Mailing Address - Street 1:200 S SERVICE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2133
Mailing Address - Country:US
Mailing Address - Phone:516-629-7080
Mailing Address - Fax:
Practice Address - Street 1:200 S SERVICE RD STE 101
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2133
Practice Address - Country:US
Practice Address - Phone:516-629-7080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-08
Last Update Date:2018-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty