Organization
PICK YOUR PATHWAY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLIE MARTIN LCSW (OWNER)
(631) 335-9573
Entity
Organization
Contact information
Practice address
10 HICKORY ST, CENTRAL ISLIP, NY 11722-4704
(631) 335-9573
Mailing address
10 HICKORY ST, CENTRAL ISLIP, NY 11722-4704
(631) 335-9573
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04932261
—
NY
Enumeration date
11/02/2022
Last updated
02/05/2024
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