Healthcare Provider Details

I. General information

NPI: 1699639575
Provider Name (Legal Business Name): NEW VISION PSYCHIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5778 COMMERCIAL ST SE STE 120
SALEM OR
97306-3076
US

IV. Provider business mailing address

553 COWART ST STE 1
LUCEDALE MS
39452-6032
US

V. Phone/Fax

Practice location:
  • Phone: 601-530-5287
  • Fax:
Mailing address:
  • Phone: 601-530-5287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: FELICIA MCNEIL
Title or Position: OWNER
Credential: NP
Phone: 601-530-5287