Healthcare Provider Details

I. General information

NPI: 1205421823
Provider Name (Legal Business Name): NEW MOMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2021
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5317 W CHICAGO AVE
CHICAGO IL
60651-2815
US

IV. Provider business mailing address

5317 W CHICAGO AVE
CHICAGO IL
60651-2815
US

V. Phone/Fax

Practice location:
  • Phone: 773-413-3470
  • Fax:
Mailing address:
  • Phone: 773-413-3470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. MELANIE GARRETT L GARRETT
Title or Position: CHIEF PROGRAM OFFICER
Credential: LCSW
Phone: 773-413-3470