Provider Demographics
NPI:1871952119
Name:VISIONS PSYCHOLOGICAL & THERAPEUTIC CENTER, PLLC
Entity type:Organization
Organization Name:VISIONS PSYCHOLOGICAL & THERAPEUTIC CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LP
Authorized Official - Phone:12182-331-0155
Mailing Address - Street 1:200 5TH ST S
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-2768
Mailing Address - Country:US
Mailing Address - Phone:218-331-0155
Mailing Address - Fax:
Practice Address - Street 1:200 5TH ST S
Practice Address - Street 2:SUITE 205
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-2768
Practice Address - Country:US
Practice Address - Phone:218-331-0155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-15
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5621251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health