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General NPI Number Information
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NPI Number | 1831895986
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Entity Type | Organization
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Legal Business Name | NEW PATH COUNSELING CENTER LLC
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Dates
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Enumeration Date | 01/31/2023
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 15896 MACKENZIE MANOR DR
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City | HAYMARKET
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State | VA
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Zip | 20169-4994
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Country | US
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Telephone | 703-986-9211
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Fax |
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Provider Business Mailing Address
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Address Line | 15896 MACKENZIE MANOR DR
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City | HAYMARKET
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State | VA
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Zip | 20169-4994
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Country | US
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Telephone | 703-986-9211
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. PEDRO JOSE RIVERA
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Credential | PSYD
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Telephone | 318-730-4705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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