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General NPI Number Information
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NPI Number | 1831729466
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Entity Type | Organization
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Legal Business Name | NEW DIRECTIONS COUNSELING CENTER
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Dates
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Enumeration Date | 01/23/2020
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Last Update Date | 01/23/2020
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Provider Practice Location Address
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Address Line | 28 E MARION ST STE 5
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City | PRINCETON
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State | IL
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Zip | 61356-2098
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Country | US
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Telephone | 815-875-2192
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Fax | 815-879-0168
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Provider Business Mailing Address
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Address Line | PO BOX 361
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City | CLINTON
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State | IA
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Zip | 52733-0361
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Country | US
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Telephone | 563-242-5316
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Fax | 563-242-3128
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Authorized Official
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Title or Position | OWNER
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Name | LISA M JOHNSON
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Credential | LCSW
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Telephone | 563-242-5316
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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 |
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License Number State |
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