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General NPI Number Information
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NPI Number | 1306186028
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Entity Type | Organization
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Legal Business Name | INNER PATHWAYS MARRIAGE AND FAMILY THERAPY, PLLC
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Dates
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Enumeration Date | 02/16/2013
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Last Update Date | 02/16/2013
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Provider Practice Location Address
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Address Line | 19 W 34TH ST PENTHOUSE FLOOR
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City | NEW YORK
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State | NY
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Zip | 10001-3006
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Country | US
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Telephone | 646-881-4608
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 ALBEMARLE RD
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City | BROOKLYN
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State | NY
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Zip | 11218-2907
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Country | US
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Telephone | 646-881-4608
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Fax |
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Authorized Official
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Title or Position | FOUNDER & OWNER
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Name | MS. KENYA FERNANDEZ
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Credential | LMFT
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Telephone | 646-881-4608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 000980
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License Number State | NY
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