Provider Demographics
NPI:1316342942
Name:NUVISTA SERVICES, LLC
Entity type:Organization
Organization Name:NUVISTA SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:FERLIN
Authorized Official - Middle Name:NATACHA
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:617-212-4803
Mailing Address - Street 1:PO BOX 72068
Mailing Address - Street 2:
Mailing Address - City:THORNDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19372-0068
Mailing Address - Country:US
Mailing Address - Phone:617-212-4803
Mailing Address - Fax:610-384-6090
Practice Address - Street 1:254 LENORA LN
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-1175
Practice Address - Country:US
Practice Address - Phone:617-212-4803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0170331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty