MEDICARE: NEW VISION PSYCHIATRY, LLC

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
1	163WP0808X	Psychiatric/Mental Health Registered Nurse

General Provider Information

NPI Number	:	1699639575
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW VISION PSYCHIATRY, LLC

Provider Business Mailing Address
First Line	:	553 COWART ST STE 1
Second Line	:
City	:	LUCEDALE
State	:	MS
Zip	:	39452-6032
Country	:	US
Telephone Number	:	601-530-5287
Fax Number	:

Provider Business Practice Location Address
First Line	:	5778 COMMERCIAL ST SE STE 120
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97306-3076
Country	:	US
Telephone Number	:	601-530-5287
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FELICIA MCNEIL
Credential	:	NP
Telephone Number	:	601-530-5287

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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