Healthcare Provider Details
I. General information
NPI: 1407507122
Provider Name (Legal Business Name): NEW BEGINNINGS THERAPY AND CONSULTING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/13/2022
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2828 KRAFT AVE SE STE 269
GRAND RAPIDS MI
49512-2076
US
IV. Provider business mailing address
2828 KRAFT AVE SE STE 269
GRAND RAPIDS MI
49512-2076
US
V. Phone/Fax
- Phone: 313-649-5129
- Fax: 616-512-6104
- Phone: 616-500-2090
- Fax: 616-469-2886
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TAMARA
SPEARS
Title or Position: CLINICAL THERAPIST/OWNER
Credential: LMSW
Phone: 616-500-2090