Healthcare Provider Details

I. General information

NPI: 1720559057
Provider Name (Legal Business Name): NEW VISIONS COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 12/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 NW 4TH ST STE 107
EVANSVILLE IN
47708-1356
US

IV. Provider business mailing address

201 NW 4TH ST STE 107
EVANSVILLE IN
47708-1356
US

V. Phone/Fax

Practice location:
  • Phone: 812-422-6812
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: WHITNEY BENNETT
Title or Position: DIRECTOR
Credential:
Phone: 812-489-3498