Provider Demographics
NPI:1083931513
Name:NEW BEGINNINGS BEHAVIORAL HEALTH SERVICES, PLLC
Entity Type:Organization
Organization Name:NEW BEGINNINGS BEHAVIORAL HEALTH SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MOORE-RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:910-429-2222
Mailing Address - Street 1:111 LAMON ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-4901
Mailing Address - Country:US
Mailing Address - Phone:910-429-2222
Mailing Address - Fax:910-429-2222
Practice Address - Street 1:111 LAMON ST
Practice Address - Street 2:SUITE 212
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-4901
Practice Address - Country:US
Practice Address - Phone:910-429-2222
Practice Address - Fax:910-429-2222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health