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NPI Code Detail

MEDICARE: NEW VISION BEHAVIORAL HEALTH SERVICES, LLC

MEDICARE: NEW VISION BEHAVIORAL HEALTH SERVICES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TA0400XAddiction (Substance Use Disorder) Psychologist
2101YA0400XAddiction (Substance Use Disorder) Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629684725
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW VISION BEHAVIORAL HEALTH SERVICES, LLC
Provider Business Mailing Address
First Line : 80 E MIDLOTHIAN BLVD
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44507-2019
Country : US
Telephone Number : 330-707-4636
Fax Number :
Provider Business Practice Location Address
First Line : 80 E MIDLOTHIAN BLVD
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44507-2019
Country : US
Telephone Number : 330-234-5251
Fax Number : 330-234-5251
Authorized Official
Title or Position : OWNER
Name : HASHEEN WILSON
Credential : MBA
Telephone Number : 330-234-5251
Provider Enumeration Date : 09/23/2020
Last Update Date : 03/20/2023

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Directions to “NEW VISION BEHAVIORAL HEALTH SERVICES, LLC ” Practice Location

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