Provider Demographics
NPI:1003578030
Name:BREATH OF NEW LIFE COUNSELING, LLC
Entity Type:Organization
Organization Name:BREATH OF NEW LIFE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CACI, SAP, PRI
Authorized Official - Phone:407-473-0068
Mailing Address - Street 1:5 GROUSE RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29617-7324
Mailing Address - Country:US
Mailing Address - Phone:407-473-0068
Mailing Address - Fax:
Practice Address - Street 1:1824 E MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3878
Practice Address - Country:US
Practice Address - Phone:407-473-0068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health