Provider Demographics
NPI:1730838509
Name:NEW VISION COUNSELING
Entity type:Organization
Organization Name:NEW VISION COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSH-CULLORS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:313-410-7308
Mailing Address - Street 1:14503 ARTESIAN ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48223-2226
Mailing Address - Country:US
Mailing Address - Phone:313-410-7308
Mailing Address - Fax:
Practice Address - Street 1:14503 ARTESIAN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48223-2226
Practice Address - Country:US
Practice Address - Phone:313-410-7308
Practice Address - Fax:313-692-6165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1992049084Medicaid