Healthcare Provider Details

I. General information

NPI: 1083640593
Provider Name (Legal Business Name): NEW HORIZONS COUNSELING SERVICE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 06/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5062 N 19TH AVE SUITE 102
PHOENIX AZ
85015-3225
US

IV. Provider business mailing address

PO BOX 56339
PHOENIX AZ
85079-6339
US

V. Phone/Fax

Practice location:
  • Phone: 623-939-6567
  • Fax: 623-939-7365
Mailing address:
  • Phone: 623-939-6567
  • Fax: 623-939-7365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberBH-1352
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberBH-2882
License Number StateAZ

VIII. Authorized Official

Name: VICKIE BINLEY
Title or Position: PRESIDENT
Credential:
Phone: 623-939-6567