Healthcare Provider Details

I. General information

NPI: 1407325541
Provider Name (Legal Business Name): NEW DIRECTIONS BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2018
Last Update Date: 11/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 ASH ST
DANVERS MA
01923-2749
US

IV. Provider business mailing address

10 ASH ST
DANVERS MA
01923-2749
US

V. Phone/Fax

Practice location:
  • Phone: 978-979-1143
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: CAROL EMERSON
Title or Position: PMHNP
Credential: PMHNP
Phone: 978-979-1143