Healthcare Provider Details

I. General information

NPI: 1104109180
Provider Name (Legal Business Name): NEW BEGINNINGS FAMILY COUNSELING SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2011
Last Update Date: 09/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 E JEFFERSON ST
CHARLOTTESVILLE VA
22902-5355
US

IV. Provider business mailing address

911 E JEFFERSON ST
CHARLOTTESVILLE VA
22902-5355
US

V. Phone/Fax

Practice location:
  • Phone: 434-984-0023
  • Fax: 434-984-4852
Mailing address:
  • Phone: 434-984-0023
  • Fax: 434-984-4852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID ELMORE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 540-943-4193