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General NPI Number Information
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NPI Number | 1013659523
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Entity Type | Organization
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Legal Business Name | NEW DESTINY COUNSELING, LLC
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Dates
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Enumeration Date | 04/13/2022
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 5 E 24TH AVE
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City | EUGENE
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State | OR
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Zip | 97405-2907
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Country | US
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Telephone | 541-515-0900
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Fax | 541-799-0789
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Provider Business Mailing Address
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Address Line | 5 E 24TH AVE
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City | EUGENE
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State | OR
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Zip | 97405-2907
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Country | US
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Telephone | 541-515-0900
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Fax |
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Authorized Official
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Title or Position | COUNSELOR/DIRECTOR
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Name | JUDITH ANA CASTRO
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Credential | LMFT
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Telephone | 541-515-0900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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