Healthcare Provider Details

I. General information

NPI: 1386250561
Provider Name (Legal Business Name): NEW BEGINNINGS COUNSELING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2020
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5930 SEMINOLE CENTRE CT STE C
FITCHBURG WI
53711-5165
US

IV. Provider business mailing address

5930 SEMINOLE CENTRE CT STE C
FITCHBURG WI
53711-5165
US

V. Phone/Fax

Practice location:
  • Phone: 608-630-8889
  • Fax: 608-200-7268
Mailing address:
  • Phone: 608-630-8889
  • Fax: 608-200-7268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: FREDERICK ANDRE HARRIS
Title or Position: OWNER/PSYCHOTHERAPIST
Credential: LPC, SAC
Phone: 608-630-8889