Healthcare Provider Details
I. General information
NPI: 1063752517
Provider Name (Legal Business Name): NEW BEGINNINGS COUNSELING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/20/2013
Last Update Date: 02/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
793-1 JUNIPER RD
VALPARAISO IN
46385-9744
US
IV. Provider business mailing address
793-1 JUNIPER RD
VALPARAISO IN
46385-9744
US
V. Phone/Fax
- Phone: 219-203-2343
- Fax:
- Phone: 219-203-2343
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | 87000481A |
| License Number State | IN |
VIII. Authorized Official
Name: MS.
SARAH
E.
BERNARD
Title or Position: OWNER
Credential: MA
Phone: 219-203-2343