Healthcare Provider Details

I. General information

NPI: 1649964677
Provider Name (Legal Business Name): NEW BEGINNINGS THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 LATIMER ST
HAZLEHURST GA
31539-6259
US

IV. Provider business mailing address

17 LATIMER ST
HAZLEHURST GA
31539-6259
US

V. Phone/Fax

Practice location:
  • Phone: 912-278-9909
  • Fax:
Mailing address:
  • Phone: 912-888-8009
  • Fax: 443-703-7810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: GISELLE REDDY
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 912-888-8009