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General NPI Number Information
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NPI Number | 1679728141
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Entity Type | Organization
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Legal Business Name | NEW DIRECTIONS COUNSELING SERVICE
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Dates
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Enumeration Date | 11/25/2008
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 31 W CENTER ST
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City | KAYSVILLE
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State | UT
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Zip | 84037-1944
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Country | US
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Telephone | 801-660-5557
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Fax | 801-732-1671
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Provider Business Mailing Address
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Address Line | 31 W CENTER ST
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City | KAYSVILLE
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State | UT
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Zip | 84037-1944
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Country | US
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Telephone | 801-660-5557
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Fax | 801-732-1671
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Authorized Official
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Title or Position | OWNER
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Name | MR. MATTHEW T LOVELAND
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Credential | LCSW
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Telephone | 801-660-5557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 292110-3501
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License Number State | UT
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