Path Forward Counseling Licensed Clinical Social Worker Services, Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PATH FORWARD COUNSELING LICENSED CLINICAL SOCIAL WORKER SERVICES, INC

Practice address

17075 Devonshire St Ste 204
Northridge, CA 91325-5408

Phone

(818) 642-6244

Fax

(818) 368-8940

NPI assigned

Jul 4, 2021

Last updated

Jul 4, 2021By 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

Mr. Frank Costello III, LCSWNPI 1811182157

Title

Owner

Phone

(818) 642-6244

Specialties & licenses 5

Addresses

Practitioners 1

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.

• Frank Costello III, L.C.S.W.

  • Clinical Social Worker
  • Northridge, CA
  • NPI 1811182157

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1625356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625356800000",
    "number": "1598336232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11218 LA MAIDA ST APT 102",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916014594",
            "telephone_number": "818-642-6244",
            "fax_number": "818-368-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST STE 204",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255408",
            "telephone_number": "818-642-6244",
            "fax_number": "818-368-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATH FORWARD COUNSELING LICENSED CLINICAL SOCIAL WORKER SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-04",
        "last_updated": "2021-07-04",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-642-6244",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alpa Patel
• Anish Jagdish Patel, M.D.
• Jaina Bhagat Patel, DPT
• Mega Harshad Patel, DDS
• Rupa Patel, RPH
• Sandhya Sudhir Pathare, MD
• Rocio Patino
• Denice Payne
• Lucas B Payor, MD
• Victor Paz

• Clinical Social Worker in Northridge, CA
• Providers in Northridge, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2021; 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.