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General NPI Number Information
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NPI Number | 1154031193
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Entity Type | Organization
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Legal Business Name | NEW PATH COUNSELING LLC
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Dates
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Enumeration Date | 11/30/2022
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | 825 E HIGHWAY 199 STE 102
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City | SPRINGTOWN
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State | TX
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Zip | 76082-2758
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Country | US
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Telephone | 682-587-7353
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Fax |
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Provider Business Mailing Address
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Address Line | 505 SUMMER TREE CT
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City | SPRINGTOWN
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State | TX
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Zip | 76082-2267
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Country | US
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Telephone | 817-946-9863
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMBER LEIGH GENTRY LOPEZ
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Credential | MED, LPC-S, RPT-S
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Telephone | 817-946-9863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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