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General NPI Number Information
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NPI Number | 1093128449
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Entity Type | Organization
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Legal Business Name | NEW BEGINNINGS THERAPY CENTER, LLC
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Dates
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Enumeration Date | 06/03/2014
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Last Update Date | 06/03/2014
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Provider Practice Location Address
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Address Line | 309 SE MAIN ST SUITE 206
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City | SIMPSONVILLE
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State | SC
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Zip | 29681-2653
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Country | US
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Telephone | 864-270-9150
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Fax | 864-252-9293
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Provider Business Mailing Address
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Address Line | 45 DOVERDALE RD
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City | GREENVILLE
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State | SC
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Zip | 29615-3935
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Country | US
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Telephone | 864-270-9150
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Fax | 864-252-9293
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | JUDITH R PHILLIPS
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Credential | L.P.C.
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Telephone | 864-270-9150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 1634
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License Number State | SC
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