Healthcare Provider Details

I. General information

NPI: 1124591490
Provider Name (Legal Business Name): NEW GROWTH COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2019
Last Update Date: 01/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 JUAN TABO BLVD NE STE 101C
ALBUQUERQUE NM
87112-1886
US

IV. Provider business mailing address

2901 JUAN TABO BLVD NE STE 101C
ALBUQUERQUE NM
87112-1886
US

V. Phone/Fax

Practice location:
  • Phone: 505-280-1928
  • Fax:
Mailing address:
  • Phone: 505-280-1928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DENISE BARNER
Title or Position: OWNER
Credential: LPCC
Phone: 505-280-1928