=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134633951
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEW-WAY COUNSELING CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/01/2017
-----------------------------------------------------
Last Update Date | 12/01/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1128 S WESTNEDGE AVE
-----------------------------------------------------
City | KALAMAZOO
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49008-1350
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 269-552-9134
-----------------------------------------------------
Fax | 269-552-1524
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1128 S WESTNEDGE AVE
-----------------------------------------------------
City | KALAMAZOO
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49008-1350
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 269-552-9134
-----------------------------------------------------
Fax | 269-552-1524
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | THERAPIST/OWNER
-----------------------------------------------------
Name | MS. ANTA LUTZ LING
-----------------------------------------------------
Credential | PHD, CADC, SAP
-----------------------------------------------------
Telephone | 269-552-9134
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------