Provider Demographics
NPI:1215209689
Name:NEW VISION COUNSELING CENTER-
Entity Type:Organization
Organization Name:NEW VISION COUNSELING CENTER-
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:801-690-3502
Mailing Address - Street 1:1916 N 700 W
Mailing Address - Street 2:SUITE 241
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-5673
Mailing Address - Country:US
Mailing Address - Phone:801-690-3502
Mailing Address - Fax:
Practice Address - Street 1:1916 N 700 W
Practice Address - Street 2:SUITE 241
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-5673
Practice Address - Country:US
Practice Address - Phone:801-690-3502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT68222416004261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT8205653-0162OtherBUSINESS REGISTRATION