Healthcare Provider Details

I. General information

NPI: 1427570043
Provider Name (Legal Business Name): NEW U BY DESIGN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2017
Last Update Date: 07/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 GRANT ST STE 2900
PITTSBURGH PA
15219-2502
US

IV. Provider business mailing address

166 HUNTING CREEK RD
CANONSBURG PA
15317-2322
US

V. Phone/Fax

Practice location:
  • Phone: 844-639-8298
  • Fax: 844-639-8298
Mailing address:
  • Phone: 724-510-9775
  • Fax: 844-639-8298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberPC009130
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPC009130
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC009130
License Number StatePA

VIII. Authorized Official

Name: MR. SHAWN ANTHONY BEARD
Title or Position: PRESIDENT
Credential: MA, NCC, LPC
Phone: 724-510-9775