Provider Demographics
NPI:1255569331
Name:NEW DIRECTIONS COUNSELING SERVICES, PLLC.
Entity type:Organization
Organization Name:NEW DIRECTIONS COUNSELING SERVICES, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:H
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:III
Authorized Official - Credentials:PHD
Authorized Official - Phone:515-233-1122
Mailing Address - Street 1:1310 SOLAR DRIVE
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701
Mailing Address - Country:US
Mailing Address - Phone:319-232-2086
Mailing Address - Fax:515-348-8260
Practice Address - Street 1:1310 SOLAR DRIVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701
Practice Address - Country:US
Practice Address - Phone:319-232-2086
Practice Address - Fax:319-232-6846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-26
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA960103TC0700X
IA00399251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA257058000Medicaid