Healthcare Provider Details

I. General information

NPI: 1851127070
Provider Name (Legal Business Name): PAOLA LUZ NAVARRETE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 CARLETON AVE
CENTRAL ISLIP NY
11722-4506
US

IV. Provider business mailing address

82 WASHINGTON AVE
HOLTSVILLE NY
11742-1029
US

V. Phone/Fax

Practice location:
  • Phone: 631-234-7807
  • Fax:
Mailing address:
  • Phone: 516-595-4707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: