Provider Demographics
NPI:1851878961
Name:THE WAY FORWARD MENTAL HEALTH COUNSELING PLLC
Entity Type:Organization
Organization Name:THE WAY FORWARD MENTAL HEALTH COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:631-619-3339
Mailing Address - Street 1:1069 MAIN ST STE 193
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-1618
Mailing Address - Country:US
Mailing Address - Phone:631-619-3339
Mailing Address - Fax:
Practice Address - Street 1:600 JOHNSON AVE STE C5
Practice Address - Street 2:
Practice Address - City:BOHEMIA
Practice Address - State:NY
Practice Address - Zip Code:11716-2669
Practice Address - Country:US
Practice Address - Phone:631-619-3339
Practice Address - Fax:631-676-2269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-21
Last Update Date:2018-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1356858617Medicaid