Healthcare Provider Details

I. General information

NPI: 1396128583
Provider Name (Legal Business Name): NEW BEGINNINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2015
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4010 W BELVEDERE AVE STE 102
BALTIMORE MD
21215-5502
US

IV. Provider business mailing address

8905 FOOTED RDG
COLUMBIA MD
21045-4216
US

V. Phone/Fax

Practice location:
  • Phone: 410-367-1089
  • Fax:
Mailing address:
  • Phone: 443-857-3045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VERNESSA TAYLOR
Title or Position: CEO
Credential:
Phone: 410-684-9202