Provider Demographics
NPI:1710870084
Name:MOVING INTO NEW DIMENSIONS THERAPEUTIC SERVICES LLLC
Entity type:Organization
Organization Name:MOVING INTO NEW DIMENSIONS THERAPEUTIC SERVICES LLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LATONYA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:DHA, LMHC EMDR
Authorized Official - Phone:561-294-5888
Mailing Address - Street 1:405 SEAFOAM CIR
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34945-1203
Mailing Address - Country:US
Mailing Address - Phone:561-294-5888
Mailing Address - Fax:
Practice Address - Street 1:405 SEAFOAM CIR
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34945-1203
Practice Address - Country:US
Practice Address - Phone:561-294-5888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health