Healthcare Provider Details

I. General information

NPI: 1174165112
Provider Name (Legal Business Name): NEW DAWN COUNSELING SPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2019
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 W LEWIS ST STE 110
PASCO WA
99301-5561
US

IV. Provider business mailing address

824 W LEWIS ST STE 110
PASCO WA
99301-5561
US

V. Phone/Fax

Practice location:
  • Phone: 509-308-4389
  • Fax:
Mailing address:
  • Phone: 509-308-4389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KYNDRA NICOLE SCOTT
Title or Position: OWNER
Credential: LICSW
Phone: 509-308-4389