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General NPI Number Information
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NPI Number | 1043137508
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Entity Type | Organization
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Legal Business Name | NEW BIRTH COUNSELING AND COMMUNITY WELLNESS PLLC
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Dates
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Enumeration Date | 07/03/2026
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Last Update Date | 07/03/2026
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Provider Practice Location Address
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Address Line | 9608 S UNION AVE
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City | CHICAGO
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State | IL
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Zip | 60628-1017
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Country | US
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Telephone | 773-307-8441
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Fax |
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Provider Business Mailing Address
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Address Line | 9624 S CICERO AVE # 234
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City | OAK LAWN
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State | IL
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Zip | 60453-3138
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Country | US
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Telephone | 773-307-8441
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | MR. ANDRE T JOHNSON
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Credential | LCSW
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Telephone | 773-307-8441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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