MEDICARE: NEW VISION COUNSELING & CONSULTATION

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
1	171M00000X	Case Manager/Care Coordinator
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1891461273
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW VISION COUNSELING & CONSULTATION

Provider Business Mailing Address
First Line	:	1404 TRAVELERS PALM DR
Second Line	:
City	:	EDGEWATER
State	:	FL
Zip	:	32132-2406
Country	:	US
Telephone Number	:	386-689-1144
Fax Number	:

Provider Business Practice Location Address
First Line	:	1404 TRAVELERS PALM DR
Second Line	:
City	:	EDGEWATER
State	:	FL
Zip	:	32132-2406
Country	:	US
Telephone Number	:	386-689-1144
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. KAREN BERKELEY
Credential	:	LCSW
Telephone Number	:	386-689-1144

Provider Enumeration Date	:	08/17/2021
Last Update Date	:	08/17/2021

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Directions to “NEW VISION COUNSELING & CONSULTATION ” Practice Location

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