| New Directions Eap Inc. | |
|
1575 Marion Ave Mansfield OH 44906-3409 | |
| (419) 529-9941 | |
| (419) 529-0496 |
| Full Name | New Directions Eap Inc. |
|---|---|
| Speciality | Counselor |
| Location | 1575 Marion Ave, Mansfield, Ohio |
| Authorized Official Name and Position | Blake Wagner (PRESIDENT) |
| Authorized Official Contact | 4195299941 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Directions Eap Inc. 1575 Marion Ave Mansfield OH 44906-3409 Ph: (419) 529-9941 | New Directions Eap Inc. 1575 Marion Ave Mansfield OH 44906-3409 Ph: (419) 529-9941 |
| NPI Number | 1295887222 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3375438609 |
|---|---|
| Medicare Enrollment ID | O20040217000238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295887222 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Blake D Wagner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013069061 PECOS PAC ID: 3971498205 Enrollment ID: I20040218000255 |
| Provider Name | Tracy L Motta-hamilton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154473825 PECOS PAC ID: 7719061621 Enrollment ID: I20080229000370 |
| Provider Name | Dianne Javurek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578844262 PECOS PAC ID: 0446411896 Enrollment ID: I20120412000312 |
| Provider Name | Christy Robin Barnes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912157413 PECOS PAC ID: 8123388485 Enrollment ID: I20200207001398 |
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