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General NPI Number Information
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NPI Number | 1174881213
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Entity Type | Organization
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Legal Business Name | A NEW BEGINNING
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Dates
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Enumeration Date | 04/26/2012
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Last Update Date | 04/26/2012
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Provider Practice Location Address
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Address Line | 120 W CHURCH ST 2
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City | FREDERICK
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State | MD
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Zip | 21701-7800
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Country | US
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Telephone | 240-415-8128
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Fax | 866-800-2569
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Provider Business Mailing Address
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Address Line | 402 PEARL ST
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City | FREDERICK
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State | MD
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Zip | 21701-6407
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Country | US
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Telephone | 410-428-9187
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Fax | 866-800-2569
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MRS. AMANDA H SHOWE
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Credential | LCSW-C
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Telephone | 410-428-9187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 16559
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License Number State | MD
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