Provider Demographics
NPI:1992331284
Name:PATH 2 LEARNING, PLLC
Entity type:Organization
Organization Name:PATH 2 LEARNING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:W
Authorized Official - Last Name:LANTIER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MBA,L-BCBA
Authorized Official - Phone:917-270-6865
Mailing Address - Street 1:5812 QUEENS BLVD APT 5O
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-7776
Mailing Address - Country:US
Mailing Address - Phone:917-270-6865
Mailing Address - Fax:347-440-0655
Practice Address - Street 1:5812 QUEENS BLVD APT 5O
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-7776
Practice Address - Country:US
Practice Address - Phone:917-270-6865
Practice Address - Fax:347-440-0655
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATH 2 POTENTIAL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY134566029OtherNYSDMV
NY000710OtherLICENSED BEHAVIOR ANALYST