MEDICARE: NEW ENLIGHTENMENT BEHAVIORAL SERVICES INC

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

General Provider Information

NPI Number	:	1942061403
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW ENLIGHTENMENT BEHAVIORAL SERVICES INC

Provider Business Mailing Address
First Line	:	PO BOX 177
Second Line	:
City	:	NORTHAMPTON
State	:	MA
Zip	:	01061-0177
Country	:	US
Telephone Number	:	631-504-2102
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 E 5TH ST FL 15
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-4119
Country	:	US
Telephone Number	:	513-952-9595
Fax Number	:	631-205-5394

Authorized Official
Title or Position	:	OWNER
Name	:	RICHARD GIRARD-DOMENA
Credential	:
Telephone Number	:	631-504-2102

Provider Enumeration Date	:	01/22/2024
Last Update Date	:	04/25/2025

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