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General NPI Number Information
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NPI Number | 1508393828
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Entity Type | Organization
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Legal Business Name | NEW REFLECTIONS COUNSELING LLC
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Dates
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Enumeration Date | 05/17/2017
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 182 BEN BURTON CIR STE 200
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City | BOGART
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State | GA
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Zip | 30622-6848
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Country | US
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Telephone | 706-224-6636
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Fax |
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Provider Business Mailing Address
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Address Line | 182 BEN BURTON CIR STE 200
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City | BOGART
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State | GA
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Zip | 30622-6848
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Country | US
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Telephone | 706-224-6636
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICKIE COLE
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Credential | LCSW
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Telephone | 706-224-6636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CSW005839
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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