MEDICARE: NEW HORIZON COUNSELING CENTER, 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	1041C0700X	Clinical Social Worker	34004695A	IN

General Provider Information

NPI Number	:	1336559319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HORIZON COUNSELING CENTER, LLC

Provider Business Mailing Address
First Line	:	PO BOX 3276
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47731-3276
Country	:	US
Telephone Number	:	812-473-0181
Fax Number	:	812-492-6498

Provider Business Practice Location Address
First Line	:	1500 WASHINGTON AVE
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47714-2059
Country	:	US
Telephone Number	:	812-491-1307
Fax Number	:	812-475-1398

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	CARRI DEGRAFFENREID
Credential	:
Telephone Number	:	812-475-1390

Provider Enumeration Date	:	04/30/2014
Last Update Date	:	04/19/2023

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