Healthcare Provider Details

I. General information

NPI: 1275839169
Provider Name (Legal Business Name): NEW HORIZONS COUNSELING CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2011
Last Update Date: 05/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9844 DIXIE HWY
IRA MI
48023-2813
US

IV. Provider business mailing address

9844 DIXIE HWY
FAIR HAVEN MI
48023
US

V. Phone/Fax

Practice location:
  • Phone: 586-716-7600
  • Fax: 586-716-7659
Mailing address:
  • Phone: 586-716-7600
  • Fax: 586-716-7659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number5101013579
License Number StateMI

VIII. Authorized Official

Name: DR. JULIE SHER
Title or Position: MEDICAL DOCTOR
Credential: DO
Phone: 586-716-7600