Provider Demographics
NPI:1003363128
Name:NEW BEGINNINGS COMMUNITY COUNSELING CENTER
Entity Type:Organization
Organization Name:NEW BEGINNINGS COMMUNITY COUNSELING CENTER
Other - Org Name:NEW BEGINNINGS COMMUNITY LIFE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TWANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-225-9915
Mailing Address - Street 1:5232 MARAGARET WALLACE ROAD
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105
Mailing Address - Country:US
Mailing Address - Phone:980-225-9915
Mailing Address - Fax:704-258-1019
Practice Address - Street 1:5232 MARAGARET WALLACE ROAD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105
Practice Address - Country:US
Practice Address - Phone:980-225-9915
Practice Address - Fax:704-258-1019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No251S00000XAgenciesCommunity/Behavioral Health