| New Way Psychological Services Llc | |
|
711 N Market Ave Bolivar MO 65613-1114 | |
| (417) 399-1793 | |
| Not Available |
| Full Name | New Way Psychological Services Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 711 N Market Ave, Bolivar, Missouri |
| Authorized Official Name and Position | Charles J Wilson (MEMBER) |
| Authorized Official Contact | 4173991793 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Way Psychological Services Llc 711 N Market Ave Bolivar MO 65613-1114 Ph: (417) 399-1793 | New Way Psychological Services Llc 711 N Market Ave Bolivar MO 65613-1114 Ph: (417) 399-1793 |
| NPI Number | 1225690175 |
|---|---|
| Provider Enumeration Date | 07/01/2019 |
| Last Update Date | 01/19/2021 |
| Certification Date | 01/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225690175 | NPI | - | NPPES |
| 101YP2500X | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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