| New Vision Therapy Pllc | |
|
810 Warren St Greensboro NC 27403-2340 | |
| (336) 517-3770 | |
| Not Available |
| Full Name | New Vision Therapy Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 810 Warren St, Greensboro, North Carolina |
| Authorized Official Name and Position | Marvin Sandifer (CEO) |
| Authorized Official Contact | 3365173770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Vision Therapy Pllc 810 Warren St Greensboro NC 27403-2340 Ph: (336) 389-1413 | New Vision Therapy Pllc 810 Warren St Greensboro NC 27403-2340 Ph: (336) 517-3770 |
| NPI Number | 1033666888 |
|---|---|
| Provider Enumeration Date | 09/08/2016 |
| Last Update Date | 06/28/2023 |
| Certification Date | 06/28/2023 |
| Medicare PECOS PAC ID | 1759612724 |
|---|---|
| Medicare Enrollment ID | O20191007002096 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033666888 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | C007317 (North Carolina) | Secondary |
| 104100000X | Social Worker | C007317 (North Carolina) | Primary |
| Provider Name | Anne D Alexander |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972522423 PECOS PAC ID: 8729992755 Enrollment ID: I20031114000209 |
| Provider Name | Marvin Mathias Sandifer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194155887 PECOS PAC ID: 2668703638 Enrollment ID: I20191007002300 |
| Provider Name | Scott Steven Sanitate |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1164439238 PECOS PAC ID: 4284065236 Enrollment ID: I20200507002469 |
| Provider Name | Caedora M Benton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427607308 PECOS PAC ID: 7214353267 Enrollment ID: I20201223002425 |
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