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General NPI Number Information
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NPI Number | 1780041343
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Entity Type | Organization
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Legal Business Name | NEW BEGINNINGS BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 01/26/2016
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Last Update Date | 03/31/2016
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Provider Practice Location Address
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Address Line | 4410 CLAIBORNE SQ E ST 334
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City | HAMPTON
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State | VA
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Zip | 23666-2071
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Country | US
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Telephone | 757-268-2891
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Fax | 855-898-1313
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Provider Business Mailing Address
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Address Line | 4410 CLAIBORNE SQ E ST 334
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City | HAMPTON
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State | VA
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Zip | 23666-2071
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Country | US
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Telephone | 757-268-2891
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Fax | 855-898-1313
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Authorized Official
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Title or Position | LCSW
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Name | JEREMIAH WILLIAMS
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Credential | LCSW
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Telephone | 757-268-2891
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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 | 0904002584
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License Number State | VA
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