Provider Demographics
NPI:1144695644
Name:NEW DIRECTIONS THERAPY AND LEARNING CENTER
Entity type:Organization
Organization Name:NEW DIRECTIONS THERAPY AND LEARNING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUSSEAU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:850-710-3702
Mailing Address - Street 1:1900 HIGHWAY 87
Mailing Address - Street 2:SUITE G
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-1061
Mailing Address - Country:US
Mailing Address - Phone:850-710-3702
Mailing Address - Fax:
Practice Address - Street 1:1900 HIGHWAY 87
Practice Address - Street 2:SUITE G
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-1061
Practice Address - Country:US
Practice Address - Phone:850-710-3702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW115921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty