Healthcare Provider Details

I. General information

NPI: 1689597445
Provider Name (Legal Business Name): NEW LIFE BEGINNINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5804 EADS ST NE
WASHINGTON DC
20019-6923
US

IV. Provider business mailing address

5804 EADS ST NE
WASHINGTON DC
20019-6923
US

V. Phone/Fax

Practice location:
  • Phone: 202-431-6266
  • Fax:
Mailing address:
  • Phone: 202-431-6266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NICHOLE LENIS BLACKMON
Title or Position: PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 202-431-6266