MEDICARE: NEW PLACE, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	171M00000X	Case Manager/Care Coordinator
3	101Y00000X	Counselor
4	251B00000X	Case Management Agency
5	101YA0400X	Addiction (Substance Use Disorder) Counselor
6	101YP2500X	Professional Counselor
7	106H00000X	Marriage & Family Therapist
8	103TC0700X	Clinical Psychologist
9	103TC1900X	Counseling Psychologist
10	1041C0700X	Clinical Social Worker
11	103K00000X	Behavior Analyst
12	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396820874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW PLACE, INC

Provider Business Mailing Address
First Line	:	6612 E. HARRIS BLVD
Second Line	:	SUITE D
City	:	CHARLOTTE
State	:	NC
Zip	:	28215
Country	:	US
Telephone Number	:	704-567-8984
Fax Number	:	704-567-8954

Provider Business Practice Location Address
First Line	:	6612 E WT HARRIS BLVD
Second Line	:	STE. D
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-5134
Country	:	US
Telephone Number	:	704-567-8984
Fax Number	:	704-567-8954

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. JAMES ARNELL HUNT
Credential	:	M.S., Q.P.
Telephone Number	:	704-567-8984

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	11/18/2010

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Directions to “NEW PLACE, INC ” Practice Location

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