Healthcare Provider Details

I. General information

NPI: 1871660068
Provider Name (Legal Business Name): A NEW BEGINNING COUNSELING CENTER,INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4115 BIRDIE LN
COHUTTA GA
30710-9100
US

IV. Provider business mailing address

4115 BIRDIE LN
COHUTTA GA
30710-9100
US

V. Phone/Fax

Practice location:
  • Phone: 706-694-4682
  • Fax: 706-694-4682
Mailing address:
  • Phone: 706-694-4682
  • Fax: 706-694-4682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC004692
License Number StateGA

VIII. Authorized Official

Name: MRS. STEPHANIE DRIGGERS HAYNES
Title or Position: PRESIDENT
Credential:
Phone: 706-694-4682