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General NPI Number Information
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NPI Number | 1770952129
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Entity Type | Organization
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Legal Business Name | NEW BEGINNINGS FAMILY CONFERENCE, LLC
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Dates
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Enumeration Date | 09/16/2015
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Last Update Date | 09/16/2015
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Provider Practice Location Address
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Address Line | 219 N HIGHWAY 52 STE B
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City | MONCKS CORNER
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State | SC
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Zip | 29461-3926
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Country | US
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Telephone | 843-761-3460
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Fax | 843-761-3462
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Provider Business Mailing Address
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Address Line | PO BOX 316
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City | GOOSE CREEK
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State | SC
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Zip | 29445-0316
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Country | US
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Telephone | 843-761-3460
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Fax | 843-761-3462
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. WANDA KAYE GALLOWAY-ROUSE
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Credential |
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Telephone | 843-291-3913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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