Provider Demographics
NPI:1093831844
Name:NEW BEGINNINGS COUNSELING SERVICE LLC
Entity Type:Organization
Organization Name:NEW BEGINNINGS COUNSELING SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:KODRICH
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:304-420-0940
Mailing Address - Street 1:3501 EMERSON AVE
Mailing Address - Street 2:SUITE 2 B
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-1849
Mailing Address - Country:US
Mailing Address - Phone:304-420-0940
Mailing Address - Fax:304-865-2214
Practice Address - Street 1:3501 EMERSON AVE
Practice Address - Street 2:SUITE 2 B
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104-1849
Practice Address - Country:US
Practice Address - Phone:304-420-0940
Practice Address - Fax:304-865-2214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1197101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV180073Medicare UPIN
WV7227387Medicare UPIN
WV000000234570Medicare UPIN
WVY288393Medicare UPIN
WV096167Medicare UPIN