Healthcare Provider Details

I. General information

NPI: 1265670467
Provider Name (Legal Business Name): NEW CHOICES COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2009
Last Update Date: 01/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2728 COLONIAL AVE SW STE 11
ROANOKE VA
24015-3876
US

IV. Provider business mailing address

2728 COLONIAL AVE SW STE 11
ROANOKE VA
24015-3876
US

V. Phone/Fax

Practice location:
  • Phone: 540-344-8600
  • Fax: 540-344-8600
Mailing address:
  • Phone: 540-344-8600
  • Fax: 540-344-8705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0718000122
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701002543
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0717000806
License Number StateVA

VIII. Authorized Official

Name: MR. DAVID BRYON GEHO
Title or Position: PRESIDENT
Credential: PRACTITIONER
Phone: 540-344-8600