| Dynamic Pathways, Lcsw, Pllc | |
|
600 Johnson Ave Ste C13 Bohemia NY 11716-2674 | |
| (631) 960-8575 | |
| (631) 315-1090 |
| Full Name | Dynamic Pathways, Lcsw, Pllc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 600 Johnson Ave Ste C13, Bohemia, New York |
| Authorized Official Name and Position | Jennifer Whaley Gundersen (OWNER) |
| Authorized Official Contact | 6319608575 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Pathways, Lcsw, Pllc 600 Johnson Ave Ste C13 Bohemia NY 11716-2674 Ph: (163) 196-0857 | Dynamic Pathways, Lcsw, Pllc 600 Johnson Ave Ste C13 Bohemia NY 11716-2674 Ph: (631) 960-8575 |
| NPI Number | 1548915804 |
|---|---|
| Provider Enumeration Date | 02/15/2022 |
| Last Update Date | 02/15/2022 |
| Certification Date | 02/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548915804 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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