Provider Demographics
NPI:1083312201
Name:NEW EDGE COUNSELING SERVICES
Entity Type:Organization
Organization Name:NEW EDGE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHUYU
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:312-989-5432
Mailing Address - Street 1:771 BROADVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-4617
Mailing Address - Country:US
Mailing Address - Phone:312-989-5432
Mailing Address - Fax:
Practice Address - Street 1:771 BROADVIEW AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-4617
Practice Address - Country:US
Practice Address - Phone:312-989-5432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty