Provider Demographics
NPI:1083080733
Name:LIGHT YOUR PATHWAY, LCSW, PLLC
Entity Type:Organization
Organization Name:LIGHT YOUR PATHWAY, LCSW, PLLC
Other - Org Name:PROGRESSIVE PSYCHOTHERAPY, LCSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-995-3457
Mailing Address - Street 1:1646 ULSTER HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:ELLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12428-5733
Mailing Address - Country:US
Mailing Address - Phone:860-995-3457
Mailing Address - Fax:888-975-1417
Practice Address - Street 1:1646 ULSTER HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:ELLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12428-5733
Practice Address - Country:US
Practice Address - Phone:860-995-3457
Practice Address - Fax:888-975-1417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-17
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5592636Medicaid
CTD300000122Medicare UPIN