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General NPI Number Information
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NPI Number | 1962732636
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Entity Type | Organization
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Legal Business Name | NEW DIRECTIONS CLINICAL THERAPY INC.
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Dates
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Enumeration Date | 01/01/2010
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Last Update Date | 12/23/2011
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Provider Practice Location Address
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Address Line | 800 W 5TH AVE SUITE 101-I
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City | NAPERVILLE
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State | IL
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Zip | 60563-8965
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Country | US
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Telephone | 630-995-9560
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Fax | 331-472-4794
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Provider Business Mailing Address
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Address Line | 800 W 5TH AVE STE 101I
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City | NAPERVILLE
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State | IL
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Zip | 60563-4948
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Country | US
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Telephone | 630-995-9560
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Fax | 331-472-4794
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Authorized Official
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Title or Position | OWNER/CLINICAL THERAPIST
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Name | MRS. ALLISON AVERY COTTON
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Credential | LCSW
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Telephone | 630-995-9560
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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 | 149.009974
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License Number State | IL
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