MEDICARE: ANEW DIRECTION COUNSELING CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	SW6232	FL

General Provider Information

NPI Number	:	1275842346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANEW DIRECTION COUNSELING CENTER, INC.

Provider Business Mailing Address
First Line	:	800 VILLAGE SQUARE XING
Second Line	:	SUITE #120
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4540
Country	:	US
Telephone Number	:	561-656-2034
Fax Number	:	561-656-2044

Provider Business Practice Location Address
First Line	:	800 VILLAGE SQUARE XING
Second Line	:	SUITE #120
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4540
Country	:	US
Telephone Number	:	561-656-2034
Fax Number	:	561-656-2044

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KAREN WASSERMAN
Credential	:	L.C.S.W.
Telephone Number	:	561-656-2034

Provider Enumeration Date	:	10/06/2010
Last Update Date	:	10/06/2010

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