Provider Demographics
NPI:1285905059
Name:NEW HOPE PSYCHIATRIC SERVICES OF THE CAROLINAS
Entity type:Organization
Organization Name:NEW HOPE PSYCHIATRIC SERVICES OF THE CAROLINAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONJA
Authorized Official - Middle Name:SIMMONS
Authorized Official - Last Name:NORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:704-491-0167
Mailing Address - Street 1:1558 UNION RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2214
Mailing Address - Country:US
Mailing Address - Phone:704-810-7418
Mailing Address - Fax:704-810-6560
Practice Address - Street 1:1558 UNION RD
Practice Address - Street 2:SUITE A
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2214
Practice Address - Country:US
Practice Address - Phone:704-810-7418
Practice Address - Fax:704-810-6560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-25
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5003959363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty