Provider Demographics
NPI:1134295439
Name:NEW CREATION COUNSELING CENTER
Entity Type:Organization
Organization Name:NEW CREATION COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:JUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:937-667-4678
Mailing Address - Street 1:7695 S COUNTY ROAD 25A
Mailing Address - Street 2:
Mailing Address - City:TIPP CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45371-9215
Mailing Address - Country:US
Mailing Address - Phone:937-667-4678
Mailing Address - Fax:937-667-4963
Practice Address - Street 1:7695 S COUNTY ROAD 25A
Practice Address - Street 2:
Practice Address - City:TIPP CITY
Practice Address - State:OH
Practice Address - Zip Code:45371-9215
Practice Address - Country:US
Practice Address - Phone:937-667-4678
Practice Address - Fax:937-667-4963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0000095251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable