Healthcare Provider Details

I. General information

NPI: 1417604265
Provider Name (Legal Business Name): NEW ERA MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2022
Last Update Date: 03/02/2022
Certification Date: 03/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5005 42ND PL N
BIRMINGHAM AL
35217-3132
US

IV. Provider business mailing address

5005 42ND PL N
BIRMINGHAM AL
35217-3132
US

V. Phone/Fax

Practice location:
  • Phone: 251-533-6643
  • Fax: 205-530-1773
Mailing address:
  • Phone: 251-533-6643
  • Fax: 205-530-1773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: EMMIT RAY ASHFORD SR.
Title or Position: CEO
Credential: ALC
Phone: 205-530-1128