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General NPI Number Information
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NPI Number | 1972020154
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Entity Type | Organization
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Legal Business Name | NEW DIRECTIONS COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 08/28/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 303 1ST AVE NE STE 220
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City | FARIBAULT
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State | MN
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Zip | 55021-5244
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Country | US
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Telephone | 507-332-8082
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Fax |
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Provider Business Mailing Address
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Address Line | 303 1ST AVE NE STE 220
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City | FARIBAULT
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State | MN
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Zip | 55021-5244
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Country | US
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Telephone | 507-332-8082
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Fax |
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Authorized Official
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Title or Position | DIRECTOR / PSYCHOLOGIST
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Name | JOHN DEFRANCISCO
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Credential | LP
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Telephone | 952-240-5330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | LP0411
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License Number State | MN
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