| Positive Pathway Lcsw Psychotherapy Pllc | |
|
191 Dorchester Rd Garden City NY 11530-5610 | |
| (516) 850-2795 | |
| Not Available |
| Full Name | Positive Pathway Lcsw Psychotherapy Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 191 Dorchester Rd, Garden City, New York |
| Authorized Official Name and Position | Kerrie Collazo (OWNER) |
| Authorized Official Contact | 5168502795 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Positive Pathway Lcsw Psychotherapy Pllc 191 Dorchester Rd Garden City NY 11530-5610 Ph: (516) 850-2795 | Positive Pathway Lcsw Psychotherapy Pllc 191 Dorchester Rd Garden City NY 11530-5610 Ph: (516) 850-2795 |
| NPI Number | 1568292506 |
|---|---|
| Provider Enumeration Date | 08/05/2024 |
| Last Update Date | 08/05/2024 |
| Certification Date | 08/05/2024 |
| Medicare PECOS PAC ID | 4981145067 |
|---|---|
| Medicare Enrollment ID | O20240916003851 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568292506 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Kerrie Collazo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780228106 PECOS PAC ID: 7214479633 Enrollment ID: I20240612003386 |
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