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NPI Code Detail

MEDICARE: NEW VISION YOUTH AND FAMILY SERVICES INC

MEDICARE: NEW VISION YOUTH AND FAMILY SERVICES INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2103T00000XPsychologist
31041C0700XClinical Social Worker
4101YP2500XProfessional Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396950614
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW VISION YOUTH AND FAMILY SERVICES INC
Provider Business Mailing Address
First Line : 112 S BROADVIEW ST
Second Line :
City : CAPE GIRARDEAU
State : MO
Zip : 63703-5759
Country : US
Telephone Number : 573-334-3486
Fax Number : 573-334-3524
Provider Business Practice Location Address
First Line : 112 S BROADVIEW ST
Second Line :
City : CAPE GIRARDEAU
State : MO
Zip : 63703-5759
Country : US
Telephone Number : 573-334-3486
Fax Number : 573-334-3524
Authorized Official
Title or Position : OFFICE MANAGER
Name : MR. MONICA GRIFFITH
Credential :
Telephone Number : 573-334-3486
Provider Enumeration Date : 05/11/2007
Last Update Date : 10/04/2022

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Directions to “NEW VISION YOUTH AND FAMILY SERVICES INC ” Practice Location

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