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General NPI Number Information
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NPI Number | 1942756309
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Entity Type | Organization
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Legal Business Name | NEW CONCEPT COUNSELING L.L.C
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Dates
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Enumeration Date | 08/26/2016
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Last Update Date | 10/07/2016
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Provider Practice Location Address
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Address Line | 6043 HUDSON RD STE 399J
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City | WOODBURY
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State | MN
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Zip | 55125-1028
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Country | US
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Telephone | 612-599-6396
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Fax | 165-156-0794
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Provider Business Mailing Address
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Address Line | 1240 DONEGAL DR
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City | WOODBURY
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State | MN
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Zip | 55125-2390
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Country | US
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Telephone | 612-599-6396
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Fax | 165-156-0794
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | DR. CHRISTOPHER ADESOJI FALADE
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Credential | DMFT LMFT
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Telephone | 612-599-6396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 2836
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License Number State | MN
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