Basic Information
Provider Information
NPI: 1366520579
EntityType: 2
ReplacementNPI:  
OrganizationName: NEW DIRECTIONS CS PLLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
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: 201 GOVERNMENT AVE SW
Address2: SUITE 305
City: HICKORY
State: NC
PostalCode: 286022954
CountryCode: US
TelephoneNumber: 8282671740
FaxNumber: 8282671746
Other Information
ProviderEnumerationDate: 11/02/2006
LastUpdateDate: 01/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BURGIN
AuthorizedOfficialFirstName: TINA
AuthorizedOfficialMiddleName: W
AuthorizedOfficialTitleorPosition: OFFICE SUPPORT STAFF
AuthorizedOfficialTelephone: 8287546087
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X5068NCN193200000X MULTI-SPECIALTY GROUPBehavioral Health & Social Service ProvidersCounselorProfessional
251S00000X  Y AgenciesCommunity/Behavioral Health 

No ID Information.


Home