Provider Demographics
NPI:1881025419
Name:NEW YORK PATHWAYS THERAPY SERVICES, LCSW PLLC
Entity Type:Organization
Organization Name:NEW YORK PATHWAYS THERAPY SERVICES, LCSW PLLC
Other - Org Name:NEW YORK PATHWAYS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:212-464-8546
Mailing Address - Street 1:481 8TH AVE # 520
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-1809
Mailing Address - Country:US
Mailing Address - Phone:212-464-8546
Mailing Address - Fax:
Practice Address - Street 1:481 8TH AVE # 520
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-1809
Practice Address - Country:US
Practice Address - Phone:212-464-8546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-08
Last Update Date:2013-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077946-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty