Provider Demographics
NPI:1972888691
Name:NEW DIRECTIONS IN BEHAVIORAL WELLNESS
Entity Type:Organization
Organization Name:NEW DIRECTIONS IN BEHAVIORAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER, CO-DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:KINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA
Authorized Official - Phone:267-642-4112
Mailing Address - Street 1:1020 ANDERS RD
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-4913
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1020 ANDERS RD
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-4913
Practice Address - Country:US
Practice Address - Phone:267-642-4112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health