Healthcare Provider Details

I. General information

NPI: 1255569331
Provider Name (Legal Business Name): NEW DIRECTIONS COUNSELING SERVICES, PLLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2009
Last Update Date: 01/23/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 SOLAR DRIVE
WATERLOO IA
50701
US

IV. Provider business mailing address

1310 SOLAR DRIVE
WATERLOO IA
50701
US

V. Phone/Fax

Practice location:
  • Phone: 319-232-2086
  • Fax: 319-232-6846
Mailing address:
  • Phone: 319-232-2086
  • Fax: 515-348-8260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number960
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number00399
License Number StateIA

VIII. Authorized Official

Name: WARREN H PHILLIPS III
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 515-233-1122