Healthcare Provider Details

I. General information

NPI: 1013070671
Provider Name (Legal Business Name): NEW REFLECTIONS COUNSELING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 04/30/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

267 REGENCY RIDGE DR
DAYTON OH
45459-4221
US

IV. Provider business mailing address

267 REGENCY RIDGE DR
DAYTON OH
45459-4221
US

V. Phone/Fax

Practice location:
  • Phone: 937-396-7077
  • Fax:
Mailing address:
  • Phone: 937-776-7290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberE6835
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE6835
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberE6835
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE6835
License Number StateOH

VIII. Authorized Official

Name: MATT PAVLIK
Title or Position: PRESIDENT
Credential: MA, LPCC-S
Phone: 937-776-7290