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General NPI Number Information
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NPI Number | 1952495467
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Entity Type | Organization
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Legal Business Name | NEW LIFE INSTITUTE
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 607 RATHERVUE PL
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City | AUSTIN
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State | TX
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Zip | 78705-3127
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Country | US
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Telephone | 512-496-9447
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Fax | 512-451-9694
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Provider Business Mailing Address
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Address Line | PO BOX 4487
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City | AUSTIN
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State | TX
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Zip | 78765-4487
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Country | US
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Telephone | 512-469-9447
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Fax | 512-451-9694
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. RAYMOND C HAWKINS
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Credential | PHD
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Telephone | 512-469-9447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 21620
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License Number State | TX
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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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