Self Initiated Living Options Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

SELF INITIATED LIVING OPTIONS INC

Doing business as

Pathway to Wellness

Practice address

3245 Route 112 Ste 1
Medford, NY 11763-1441

Phone

(631) 880-7929

NPI assigned

Dec 18, 2023

Last updated

Dec 18, 2023By 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

Laurie Delgado

Title

Am

Phone

(631) 880-7929

Specialties & licenses 1

Addresses

Other names 1

• Pathway to Wellness Doing business as

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brianna Albano-Niedzwieski

  • Clinical Social Worker
  • Medford, NY
  • NPI 1669147971
  NPD
• Ecaterina Henter, LMSW

  • Social Worker
  • Medford, NY
  • NPI 1154003598
  NPD
• John Karahalis

  • School Psychologist
  • Medford, NY
  • NPI 1114675923
  NPD
• Kelsey Rose Kalafut, LMSW

  • Social Worker
  • Medford, NY
  • NPI 1770260846
  NPD (past)

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1558139709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3253 ROUTE 112 BLDG 10",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631411",
            "telephone_number": "631-880-7329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 ROUTE 112 STE 1",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631441",
            "telephone_number": "631-880-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF INITIATED LIVING OPTIONS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "DELGADO",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "AM",
        "authorized_official_telephone_number": "631-880-7929"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pathway to Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christie Lyn Schrank-Krupa, MS, BCBA, LBA
• Lena Scotti
• Abby Sear, LCSW
• Roon Sebastian, LMSW
• Self Initiated Living Options Inc
• Seniorbridge Family Companies (Ny), Inc
• Rhiannon Skye Sgambati
• Badrud D Shaikh
• Jaclyn Kristin Shea
• Daniel Shin, PHARM.D

• Mental Health Clinic/Center (Including Community Mental Health Center) in Medford, NY
• Providers in Medford, NY by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.