MEDICARE: A NEW STORY COUNSELING, PLLC

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	251S00000X	Community/Behavioral Health Agency	71217	TX

General Provider Information

NPI Number	:	1710361449
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A NEW STORY COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	5904 S COOPER ST
Second Line	:	SUITE 104-PMB 118
City	:	ARLINGTON
State	:	TX
Zip	:	76017-4494
Country	:	US
Telephone Number	:	325-439-9181
Fax Number	:

Provider Business Practice Location Address
First Line	:	5904 S COOPER ST
Second Line	:	SUITE 104-PMB 118
City	:	ARLINGTON
State	:	TX
Zip	:	76017-4494
Country	:	US
Telephone Number	:	325-439-9181
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	KRISTIE STORY
Credential	:	MA, LPC
Telephone Number	:	325-439-9181

Provider Enumeration Date	:	07/13/2015
Last Update Date	:	07/13/2015

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