Provider Demographics
NPI:1831658293
Name:NEW FOCUS CENTER, LLC
Entity Type:Organization
Organization Name:NEW FOCUS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LCSW
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:TREY
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:903-715-4480
Mailing Address - Street 1:1849 LAMAR AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-1463
Mailing Address - Country:US
Mailing Address - Phone:903-715-4480
Mailing Address - Fax:
Practice Address - Street 1:1849 LAMAR AVE STE 120
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-1463
Practice Address - Country:US
Practice Address - Phone:903-715-4480
Practice Address - Fax:903-723-8211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-15
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX397103801Medicaid