Healthcare Provider Details

I. General information

NPI: 1932983111
Provider Name (Legal Business Name): NEW U HOLISTIC THERAPIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 WASHINGTON ST UNIT 1212
FAIRBURN GA
30213-3609
US

IV. Provider business mailing address

75 WASHINGTON ST UNIT 1212
FAIRBURN GA
30213-3609
US

V. Phone/Fax

Practice location:
  • Phone: 470-387-0522
  • Fax: 844-523-6852
Mailing address:
  • Phone: 470-387-0522
  • Fax: 844-523-6852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 9
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: JESSI'CA COLEY
Title or Position: OWNER
Credential:
Phone: 470-387-0522