Provider Demographics
NPI:1154031193
Name:NEW PATH COUNSELING LLC
Entity type:Organization
Organization Name:NEW PATH COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:LEIGH GENTRY
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC-S, RPT-S
Authorized Official - Phone:817-946-9863
Mailing Address - Street 1:505 SUMMER TREE CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:76082-2267
Mailing Address - Country:US
Mailing Address - Phone:817-946-9863
Mailing Address - Fax:
Practice Address - Street 1:825 E HIGHWAY 199
Practice Address - Street 2:STE 102
Practice Address - City:SPRINGTOWN
Practice Address - State:TX
Practice Address - Zip Code:76082-2758
Practice Address - Country:US
Practice Address - Phone:682-587-7353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health