Basic Information
| Provider Information | |||||||||
| NPI: | 1922581610 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW DAY THERAPY, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1605 GRAND CENTRAL AVE STE C | ||||||||
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| City: | VIENNA | ||||||||
| State: | WV | ||||||||
| PostalCode: | 261051081 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042953345 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1605 GRAND CENTRAL AVE STE C | ||||||||
| Address2: | |||||||||
| City: | VIENNA | ||||||||
| State: | WV | ||||||||
| PostalCode: | 261051081 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042953345 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/10/2018 | ||||||||
| LastUpdateDate: | 04/03/2019 | ||||||||
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| AuthorizedOfficialLastName: | PHILPOTT | ||||||||
| AuthorizedOfficialFirstName: | RUSSELL | ||||||||
| AuthorizedOfficialMiddleName: | DEAN | ||||||||
| AuthorizedOfficialTitleorPosition: | LICENSED PROFESSIONAL COUNSELOR | ||||||||
| AuthorizedOfficialTelephone: | 3042953345 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.ED., LPC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.