Healthcare Provider Details

I. General information

NPI: 1023770047
Provider Name (Legal Business Name): NEW ENGLAND COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2021
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11730 ROCKAWAY LN
FAIRFAX VA
22030-7940
US

IV. Provider business mailing address

10 BANK ST STE 830
WHITE PLAINS NY
10606-1952
US

V. Phone/Fax

Practice location:
  • Phone: 703-570-5300
  • Fax:
Mailing address:
  • Phone: 646-709-6883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DANIEL LENZO
Title or Position: VP
Credential:
Phone: 646-709-6883