MEDICARE: NEW BEGINNINGS CHRISTIAN COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1013540699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW BEGINNINGS CHRISTIAN COUNSELING LLC

Provider Business Mailing Address
First Line	:	2227 SHADOWRIDGE CT
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-7530
Country	:	US
Telephone Number	:	405-928-0010
Fax Number	:

Provider Business Practice Location Address
First Line	:	11209 N MAY AVE STE B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-6351
Country	:	US
Telephone Number	:	405-928-0010
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	DONNULETTE D DULANEY
Credential	:	LPC
Telephone Number	:	405-928-0010

Provider Enumeration Date	:	02/21/2020
Last Update Date	:	02/21/2020

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