Provider Demographics
NPI:1134749633
Name:NEW VISION THERAPY & WELLNESS, PLLC
Entity type:Organization
Organization Name:NEW VISION THERAPY & WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOFFATT
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:803-448-1590
Mailing Address - Street 1:747 HALL SPENCER RD
Mailing Address - Street 2:
Mailing Address - City:CATAWBA
Mailing Address - State:SC
Mailing Address - Zip Code:29704-9401
Mailing Address - Country:US
Mailing Address - Phone:803-448-1590
Mailing Address - Fax:888-416-8540
Practice Address - Street 1:11709 FRUEHAUF DR STE 124
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-7286
Practice Address - Country:US
Practice Address - Phone:803-448-1590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty