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Organization
PATHWAYS OF HOPE LCSW'S
Active
Organization
PATHWAYS OF HOPE LCSW'S
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KOKONA NISSA PERRY LCSW (LICENSED CLINICAL SOCIAL WORKER)
(917) 319-6032
Entity
Organization
Contact information
Practice address
121 AVISTON ST, STATEN ISLAND, NY 10306-5315
(917) 319-6032
Mailing address
121 AVISTON ST, STATEN ISLAND, NY 10306-5315
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
071613-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00071613
—
NY
Enumeration date
02/18/2015
Last updated
02/18/2015
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