Healthcare Provider Details

I. General information

NPI: 1629326194
Provider Name (Legal Business Name): NEW DIRECTIONS COUNSELING CENTER IN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2012
Last Update Date: 01/12/2022
Certification Date: 11/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 21ST AVE #112
LONGMONT CO
80501-3420
US

IV. Provider business mailing address

16 MOUNTAIN VIEW AVE #109
LONGMONTH CO
80501
US

V. Phone/Fax

Practice location:
  • Phone: 720-201-6230
  • Fax: 303-682-9474
Mailing address:
  • Phone: 720-201-6230
  • Fax: 937-734-4343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number470
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. JUDI ASHLEY
Title or Position: THERAPIST
Credential: MA LMFT CAC LLL
Phone: 720-201-6230