MEDICARE: CREATING NEW BEGINNINGS COUNSELING & CONSULTING 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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1154097178
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREATING NEW BEGINNINGS COUNSELING & CONSULTING LLC

Provider Business Mailing Address
First Line	:	1135 HUNTINGTON PLACE CIR
Second Line	:
City	:	LITHONIA
State	:	GA
Zip	:	30058-3036
Country	:	US
Telephone Number	:	404-202-2061
Fax Number	:

Provider Business Practice Location Address
First Line	:	3350 NORTHLAKE PKWY NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30345-2204
Country	:	US
Telephone Number	:	404-202-2061
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CANDICE NORRIS-BROWN
Credential	:	PHD
Telephone Number	:	404-202-2061

Provider Enumeration Date	:	08/19/2021
Last Update Date	:	08/19/2021

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