Provider Demographics
NPI:1366719833
Name:NEW DIRECTION
Entity type:Organization
Organization Name:NEW DIRECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:304-237-2264
Mailing Address - Street 1:P.O. BOX 633
Mailing Address - Street 2:423 BAILEY AVE
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25802
Mailing Address - Country:US
Mailing Address - Phone:304-237-2264
Mailing Address - Fax:888-362-8827
Practice Address - Street 1:423 BAILEY AVE
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801
Practice Address - Country:US
Practice Address - Phone:304-237-2264
Practice Address - Fax:888-362-8827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAP00943402104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty