MEDICARE: NEW LOOK 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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1912461880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW LOOK COUNSELING LLC

Provider Business Mailing Address
First Line	:	1282 SMALLWOOD DR W
Second Line	:	PMB #423
City	:	WALDORF
State	:	MD
Zip	:	20603
Country	:	US
Telephone Number	:	301-512-0021
Fax Number	:

Provider Business Practice Location Address
First Line	:	11705 BERRY RD STE 104
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20603-5933
Country	:	US
Telephone Number	:	301-512-0021
Fax Number	:

Authorized Official
Title or Position	:	OWNER/COUNSELOR
Name	:	KIERRA JORDAN
Credential	:	LCPC-S, NCC
Telephone Number	:	301-512-0021

Provider Enumeration Date	:	01/25/2019
Last Update Date	:	01/25/2019

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Directions to “NEW LOOK COUNSELING LLC ” Practice Location

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