Wellness Path

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

R046289-1 Issued in NY

Legal business name

WELLNESS PATH

Practice address

209 Oswego St
Space#13
Liverpool, NY 13088-1502

Phone

(315) 457-7047

Fax

(315) 457-0719

NPI assigned

Dec 31, 2014

Last updated

Dec 31, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nahid Masrouri, LCSW-R

Title

Ceo

Phone

(315) 457-7047

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1419984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419984000000",
    "number": "1427446301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 OSWEGO ST",
            "address_2": "SPACE#13",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130881502",
            "telephone_number": "315-457-7047",
            "fax_number": "315-457-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 OSWEGO ST",
            "address_2": "SPACE#13",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130881502",
            "telephone_number": "315-457-7047",
            "fax_number": "315-457-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS PATH",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-31",
        "last_updated": "2014-12-31",
        "status": "A",
        "authorized_official_last_name": "MASROURI",
        "authorized_official_first_name": "NAHID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "315-457-7047",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "NY",
            "license": "R046289-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Liverpool, NY
• Providers in Liverpool, NY by specialty
• Professional Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.