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General NPI Number Information
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NPI Number | 1669994158
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Entity Type | Organization
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Legal Business Name | NEW CREATION COUNSELING LLC
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Dates
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Enumeration Date | 07/17/2017
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Last Update Date | 06/30/2021
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Provider Practice Location Address
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Address Line | 503 SOUTH PALM AVE.
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City | TITUSVILLE
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State | FL
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Zip | 32796
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Country | US
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Telephone | 321-735-8113
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Fax | 833-921-0180
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Provider Business Mailing Address
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Address Line | 503 SOUTH PALM AVE.
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City | TITUSVILLE
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State | FL
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Zip | 32796
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Country | US
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Telephone | 321-735-8113
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Fax | 833-921-0180
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Authorized Official
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Title or Position | PRESIDENT/SOLE PROPRIETOR
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Name | MS. ROBIN MARIE AHLGREN
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Credential | LCSW
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Telephone | 321-735-8113
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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 | SW13070
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License Number State | FL
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