Organization
NEW PATH WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTOINE JACQUES (OWNER)
(561) 814-3968
Entity
Organization
Contact information
Practice address
3175 S CONGRESS AVE, 204, PALM SPRINGS, FL 33461-2500
(561) 814-3968
Mailing address
3175 S CONGRESS AVE, 204, PALM SPRINGS, FL 33461-2500
(561) 814-3968
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TE1100X
Exercise & Sports Psychologist
—
—
103TH0004X
Health Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
103TP0016X
Prescribing (Medical) Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
103TR0400X
Rehabilitation Psychologist
—
—
Other
Enumeration date
01/18/2017
Last updated
01/18/2017
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