Healthcare Provider Details

I. General information

NPI: 1962346163
Provider Name (Legal Business Name): NEW SEASON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 4TH AVE S
BIRMINGHAM AL
35233-2521
US

IV. Provider business mailing address

308 BRANDY LN
HARPERSVILLE AL
35078-5313
US

V. Phone/Fax

Practice location:
  • Phone: 856-630-8158
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: TAYA AMANI RANDALL
Title or Position: SUBSTANCE THERAPIST
Credential: MSW
Phone: 856-630-8158