Healthcare Provider Details

I. General information

NPI: 1497600613
Provider Name (Legal Business Name): NEW PATHWAYS TO WELLNESS, MENTAL HEALTH COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 E MAPLE ST
VALLEY STREAM NY
11580
US

IV. Provider business mailing address

144 E MAPLE ST
VALLEY STREAM NY
11580-4621
US

V. Phone/Fax

Practice location:
  • Phone: 347-423-0918
  • Fax:
Mailing address:
  • Phone: 347-423-0918
  • 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: LAKISHA FULMORE
Title or Position: OWNER
Credential: FULMORE
Phone: 347-423-0918