New Concept Self Development Center, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

42106000 Issued in WI

Legal business name

NEW CONCEPT SELF DEVELOPMENT CENTER, INC.

Practice address

4828 W Fond Du Lac Ave
Milwaukee, WI 53216-2323

Phone

(414) 444-1952

Fax

(414) 444-2863

NPI assigned

Apr 16, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Vanessa Key, MSM BSW

Title

Ceopresident

Phone

(414) 444-1952

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982829040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4828 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162323",
            "telephone_number": "414-444-1952",
            "fax_number": "414-444-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4828 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162323",
            "telephone_number": "414-444-1952",
            "fax_number": "414-444-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW CONCEPT SELF DEVELOPMENT CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KEY",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "CEOPRESIDENT",
        "authorized_official_telephone_number": "414-444-1952",
        "authorized_official_credential": "MSM BSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "42106000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.