Healthcare Provider Details

I. General information

NPI: 1245070820
Provider Name (Legal Business Name): NEW HORIZONS COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25020 SHORE PKWY STE K
ONLEY VA
23418-2857
US

IV. Provider business mailing address

PO BOX 1153
EXMORE VA
23350-1153
US

V. Phone/Fax

Practice location:
  • Phone: 757-709-0996
  • Fax: 757-460-7744
Mailing address:
  • Phone: 757-709-0996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN WILLIS KONKEL
Title or Position: OWNER
Credential: LPC
Phone: 757-709-0996