Basic Information
| Provider Information | |||||||||
| NPI: | 1104957265 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW DIRECTIONS CS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 GOVERNMENT AVE SW | ||||||||
| Address2: | SUITE 305 | ||||||||
| City: | HICKORY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286022954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282671740 | ||||||||
| FaxNumber: | 8282671746 | ||||||||
| Practice Location | |||||||||
| Address1: | 315 WILKESBORO BLVD NE STE 1A | ||||||||
| Address2: | |||||||||
| City: | LENOIR | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286454498 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8287546087 | ||||||||
| FaxNumber: | 8287541344 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2007 | ||||||||
| LastUpdateDate: | 01/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | MEOSKY | ||||||||
| AuthorizedOfficialFirstName: | GARY | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGING PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 8282671740 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
| NPICertificationDate: | 01/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional | 1041C0700X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 251S00000X | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 6005852 | 05 | NC | MEDICAID |