Provider Demographics
NPI:1891402673
Name:NEW PATHWAYS TO WELLNESS, LLC
Entity Type:Organization
Organization Name:NEW PATHWAYS TO WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAKISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FULMORE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:516-774-1341
Mailing Address - Street 1:205 ROCKAWAY AVE # 1027
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-5825
Mailing Address - Country:US
Mailing Address - Phone:516-774-1341
Mailing Address - Fax:516-531-8959
Practice Address - Street 1:205 ROCKAWAY AVE # 1027
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-5825
Practice Address - Country:US
Practice Address - Phone:516-774-1341
Practice Address - Fax:516-531-8959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty