Provider Demographics
NPI:1962429811
Name:NEW VISION PROFESSIONAL COUNSELING, PC
Entity type:Organization
Organization Name:NEW VISION PROFESSIONAL COUNSELING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MAGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, MAMFT, MACC
Authorized Official - Phone:405-921-7776
Mailing Address - Street 1:8601 NW 105TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-1224
Mailing Address - Country:US
Mailing Address - Phone:405-921-7776
Mailing Address - Fax:405-603-5309
Practice Address - Street 1:11212 N MAY AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-6336
Practice Address - Country:US
Practice Address - Phone:405-921-7776
Practice Address - Fax:405-603-5309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2098101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty