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General NPI Number Information
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NPI Number | 1790415578
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Entity Type | Organization
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Legal Business Name | NEW LIFE ADDICTION COUNSELING SERVICES, INC.
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 12/13/2022
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Provider Practice Location Address
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Address Line | 8114 SANDPIPER CIR STE 213-215
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City | NOTTINGHAM
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State | MD
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Zip | 21236-4934
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Country | US
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Telephone | 410-255-4475
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Fax |
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Provider Business Mailing Address
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Address Line | 7240 PARKWAY DR STE 140
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City | HANOVER
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State | MD
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Zip | 21076-1367
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Country | US
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Telephone | 410-255-4475
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | LINDA DUMSHA
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Credential |
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Telephone | 410-255-4475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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