1699821975 NPI number — NEW VISION COUNSELING SERVICE,LLC

Table of content: (NPI 1699821975)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699821975 NPI number — NEW VISION COUNSELING SERVICE,LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW VISION COUNSELING SERVICE,LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699821975
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
105 STONY POINTE WAY
Provider Second Line Business Mailing Address:
SUITE 221
Provider Business Mailing Address City Name:
STRASBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22657-2670
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-465-4441
Provider Business Mailing Address Fax Number:
540-465-4439

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 STONY POINTE WAY
Provider Second Line Business Practice Location Address:
SUITE 221
Provider Business Practice Location Address City Name:
STRASBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22657-2670
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-465-4441
Provider Business Practice Location Address Fax Number:
540-465-4439
Provider Enumeration Date:
01/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GARRETT
Authorized Official First Name:
DOROTHY
Authorized Official Middle Name:
LOUISE
Authorized Official Title or Position:
LCSW
Authorized Official Telephone Number:
540-465-4441

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  0904004873 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 084566 . This is a "COMMUNITY HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 184328 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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