Healthcare Provider Details

I. General information

NPI: 1376783258
Provider Name (Legal Business Name): NEW BEGINNINGS MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2009
Last Update Date: 03/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

834 AVENUE D
FORT MADISON IA
52627-2836
US

IV. Provider business mailing address

834 AVENUE D
FORT MADISON IA
52627-2836
US

V. Phone/Fax

Practice location:
  • Phone: 319-371-9376
  • Fax:
Mailing address:
  • Phone: 319-371-9376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. MICHAEL J PIERCE
Title or Position: COUNSELOR
Credential: M.S.E. COUNSELING
Phone: 319-371-9376