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General NPI Number Information
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NPI Number | 1871853572
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Entity Type | Organization
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Legal Business Name | NEW VISIONS MENTAL HEALTH SERVICE LLC
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Dates
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Enumeration Date | 05/29/2012
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Last Update Date | 05/29/2012
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Provider Practice Location Address
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Address Line | 5 GREENTREE CTR SUITE 201
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City | MARLTON
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State | NJ
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Zip | 08053-3422
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Country | US
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Telephone | 856-817-6084
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Fax |
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Provider Business Mailing Address
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Address Line | 5 GREENTREE CTR SUITE 201
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City | MARLTON
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State | NJ
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Zip | 08053-3422
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Country | US
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Telephone | 856-817-6084
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. LAUREEN LINDER
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Credential | LCSW
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Telephone | 856-817-6084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 44SC05368500
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License Number State | NJ
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