Provider Demographics
NPI: | 1184264533 |
---|---|
Name: | NEW VISION COUNSELING CENTER |
Entity type: | Organization |
Organization Name: | NEW VISION COUNSELING CENTER |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CLINICAL SUPERVISOR |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | JULIE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HAYDEN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PSYD |
Authorized Official - Phone: | 858-848-1766 |
Mailing Address - Street 1: | 8050 LA MESA BLVD |
Mailing Address - Street 2: | |
Mailing Address - City: | LA MESA |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 91942-0335 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 619-273-3549 |
Mailing Address - Fax: | 619-463-2522 |
Practice Address - Street 1: | 8050 LA MESA BLVD |
Practice Address - Street 2: | |
Practice Address - City: | LA MESA |
Practice Address - State: | CA |
Practice Address - Zip Code: | 91942-0335 |
Practice Address - Country: | US |
Practice Address - Phone: | 619-273-3549 |
Practice Address - Fax: | 619-463-2522 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-01-14 |
Last Update Date: | 2024-12-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | |
No | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent | Group - Multi-Specialty |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty | |
No | 103TA0400X | Behavioral Health & Social Service Providers | Psychologist | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
No | 103TC1900X | Behavioral Health & Social Service Providers | Psychologist | Counseling | Group - Multi-Specialty |
No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | ||
No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | |
No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | |
No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | |
No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |