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General NPI Number Information
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NPI Number | 1134300403
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Entity Type | Organization
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Legal Business Name | NEW HORIZONS COUNSELING SERVICES, INC.
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 3915 N SHERIDAN RD UNIT R
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City | PEORIA
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State | IL
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Zip | 61614-7135
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Country | US
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Telephone | 309-681-9432
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Fax | 309-681-9164
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Provider Business Mailing Address
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Address Line | 3915 R N SHERIDAN RD
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City | PEORIA
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State | IL
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Zip | 61614-7135
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Country | US
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Telephone | 309-681-9432
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Fax | 309-681-9164
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Authorized Official
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Title or Position | FOUNDER
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Name | DR. JIMMY LOUIS PHILLIPS
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Credential | LCPC
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Telephone | 309-681-9432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180000228
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License Number State | IL
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