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General NPI Number Information
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NPI Number | 1679938062
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Entity Type | Organization
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Legal Business Name | NEW WINGS COUNSELING, LLC
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Dates
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Enumeration Date | 12/29/2015
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Last Update Date | 12/29/2015
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Provider Practice Location Address
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Address Line | 4701 OLENTANGY RIVER RD SUITE 201
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City | COLUMBUS
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State | OH
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Zip | 43214-1950
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Country | US
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Telephone | 614-209-8948
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Fax |
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Provider Business Mailing Address
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Address Line | 4701 OLENTANGY RIVER RD SUITE 201
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City | COLUMBUS
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State | OH
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Zip | 43214-1950
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Country | US
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Telephone | 614-209-8948
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENISE HARMON
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Credential | LISW-S
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Telephone | 614-209-8948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | I.1101322-S
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License Number State | OH
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