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General NPI Number Information
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NPI Number | 1528480175
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Entity Type | Organization
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Legal Business Name | NEW DAY PSYCHOLOGICAL SERVICES AND CONSULTING
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Dates
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Enumeration Date | 01/16/2014
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Last Update Date | 01/16/2014
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Provider Practice Location Address
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Address Line | 1106 SANTA FE TRL STE 2
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City | DUNCANVILLE
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State | TX
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Zip | 75137-3063
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Country | US
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Telephone | 972-454-9304
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Fax | 972-559-0009
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Provider Business Mailing Address
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Address Line | PO BOX 181204
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City | ARLINGTON
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State | TX
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Zip | 76096-1204
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Country | US
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Telephone | 972-454-9304
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Fax | 972-559-0009
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Authorized Official
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Title or Position | OWNER
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Name | TICILY C MEDLEY
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Credential | PHD, LMFT
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Telephone | 972-454-9304
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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 | 201021
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License Number State | TX
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